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Tenecteplase for Acute Ischaemic Stroke in patients with large vessel occlusions

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  3. Tenecteplase for Acute Ischaemic Stroke in patients with large vessel occlusions

Who can administer

Doctor only

Important information

  • This monograph refers to the use of tenecteplase for STROKE indication. For use in MYOCARDIAL INFARCTION.seeseparate monograph
  • Should be used under guidance of Stroke Consultant
  • Tenecteplase should ONLY BE ADMINISTERED in a line containing Sodium chloride 0.9% (AVOID Glucose 5%)
  • Unlicensed preparation

Available preparations

TNKase 50mg vial powder for solution

Supplied with 10ml Water for Injection vial

Reconstitution

Missing media item.

  • Remove the shield assembly from the supplied B-D 10ml syringe (shield assembly consists of the last three components on the right hand side of the picture above) - do not discard this part as it is required later
  • Aseptically withdraw 10ml Water for injection from the supplied diluent vial using the syringe with the red hub cannula (must use Water for injection vial that is supplied with the product)
  • Inject this 10ml diluent into the vial containing the drug, directing the diluent stream into the powder.
  • Slight foaming on reconstitution is to be expected.
  • Allow to stand for several minutes to allow bubbles to dissipate
  • Gently swirl until the contents are completely dissolved and DO NOT SHAKE
  • Withdraw the required volume into the syringe, using the red hub cannula
  • Using the shield assembly device that was removed earlier: stand the shield vertically on a flat surface (with green side down) and passively recap the red hub cannula
  • Remove the entire shield assembly, including the red hub cannula by twisting counter-clockwise.

Infusion fluids

  • Not required

Methods of intravenous administration

Bolus Intravenous Injection

  • Administer over approximately 10 seconds

Dose in adults

Dose in adults:

  • Give 0.25mg/kg (MAXIMUM of 25mg) as a single IV bolus over approximately 10 seconds
  • See table below
  • A pre-existing intravenous line may be used, ONLY if sodium chloride 0.9% has been infused (AVOID glucose 5%).
Patient weight (kg) Tenecteplase dose (mg) Volume of reconstituted Tenecteplase solution required (mL)
30 7.5mg 1.5mL
35 8.75mg 1.75mL
40 10mg 2mL
45 11.25mg 2.25mL
50 12.5mg 2.5mL
55 13.75mg 2.75mL
60 15mg 3mL
65 16.25mg 3.25mL
70 17.5mg 3.5mL
75 18.75mg 3.75mL
80 20mg 4mL
85 21.25mg 4.25mL
90 22.5mg 4.5mL
95 23.75mg 4.75mL
100 25mg (maximum dose) 5mL (maximum volume)

 

Monitoring

  • As per Stroke pathway

Storage

  • Store unreconstituted product at room temperature

References

TNKase SPC January 2018

Therapeutic classification

Thrombolytic