Metalyse

Tenecteplase

Thrombolytic treatment of acute MI.

IV Given as single IV bolus over 5-10 sec. Administer as early as possible after symptom onset. Max dose: 10,000 u (50 mg). Patient weighing ≥90 kg 10,000 u (50 mg), ≥80 to <90 kg 9,000 u (45 mg), ≥70 to <80 kg 8,000 u (40 mg), ≥60 to <70 kg 7,000 u (35 mg), <60 kg 6,000 u (30 mg).

Hypersensitivity to tenecteplase or gentamicin. Significant bleeding disorder (present or w/in past 6 mth), known haemorrhagic diathesis; history of CNS damage ie, neoplasm, aneurysm, intracranial or spinal surgery; severe uncontrolled arterial HTN; major surgery, parenchymal organ biopsy or significant trauma w/in past 2 mth, recent head or cranial trauma; prolonged or traumatic CPR (>2 min) w/in past 2 wk; active peptic ulceration; arterial aneurysm & known arterial/venous malformation; neoplasm w/ increased bleeding risk; acute pericarditis &/or subacute bacterial endocarditis; acute pancreatitis; haemorrhagic stroke or stroke of unknown origin at any time; ischaemic stroke or transient ischaemic attack in the preceding 6 mth. Concomitant treatment w/ oral anticoagulant (INR >1.3). Severe hepatic dysfunction including hepatic failure, cirrhosis, portal HTN (oesophageal varices) & active hepatitis.

Discontinue use if anaphylactoid reaction occurs. Terminate concomitant heparin administration if serious bleeding particularly cerebral haemorrhage occurs. Not to be given if primary percutaneous coronary intervention (PCI) is scheduled according to current relevant treatment guidelines as administered in the ASSENT-4 PCI study. Bleeding; reperfusion arrhythmias. Systolic BP >160 mmHg; recent GI or genitourinary bleeding w/in past 10 days; recent IM inj w/in past 2 days; low body wt <60 kg; cerebrovascular disease. Increased risk of bleeding w/ concomitant use of GPIIb/IIIa antagonists; thromboembolic events in patients w/ left heart thrombus eg, mitral stenosis or atrial fibrillation. Avoid use of rigid catheters, IM inj & non-essential handling of patient during treatment. Consider protamine administration if heparin has been administered w/in 4 hr before onset of bleeding; cryoprecipitate, fresh frozen plasma, & platelet transfusion after each administration; antifibrinolytics. Transfer w/o delay to coronary intervention capable facility for angiography & timely coronary intervention w/in 6-24 hr or earlier. Concomitant use w/ heparin or oral anticoagulants. Pregnancy & lactation. Elderly >75 yr.

Haemorrhage (superficial & internal bleeding) at any site or body cavity. Intracranial hemorrhagic neurological symptoms eg, somnolence, aphasia, hemiparesis, convulsion; anaphylactoid reactions including rash, urticaria, bronchospasm, laryngeal oedema; intracranial haemorrhage eg, cerebral & subarachnoid haemorrhage, cerebral & intracranial haematoma, haemorrhagic & haemorrhagic transformation stroke; eye haemorrhage; reperfusion arrhythmias (eg, asystole, accelerated idioventricular arrhythmia, arrhythmia, extrasystoles, atrial fibrillation, 1st degree AV block, bradycardia, tachycardia, ventricular arrhythmia, fibrillation & tachycardia), pericardial haemorrhage; embolism; epistaxis, pulmonary haemorrhage; GI haemorrhage (eg, gastric, gastric ulcer, rectal & mouth haemorrhage, haematemesis, malaena), nausea, vomiting, retroperitoneal haemorrhage eg, retroperitoneal haematoma; ecchymosis; urogenital haemorrhage eg, haematuria, haemorrhage urinary tract; inj & puncture site haemorrhage; decreased BP, increased body temp; fat embolism; transfusion.

Increased risk of bleeding w/ medicinal products that affect coagulation or alter platelet function.

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

B01AD11 - tenecteplase ; Belongs to the class of enzymes. Used in the treatment of thrombosis.

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