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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.see SPC
- Should be used under guidance of Thrombolysis Consultant
- Tenecteplase should ONLY BE ADMINISTERED in a line containing Sodium chloride 0.9% (AVOID Glucose 5%)
- In order to improve the traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded.
Available preparations
Metalyse 5,000 units (25mg) vial
Reconstitution
Water for injection
- 5 mL per 5,000 unit (25mg vial)
- Add slowly to avoid foaming
- Keeping the syringe attached reconstitute the solution by swirling gently to avoid foaming
- Transfer the appropriate volume of Metalyse reconstituted solution into the syringe
Infusion fluids
- Not required
Methods of intravenous administration
Bolus Intravenous Injection
- Administer over approximately 5 to 10 seconds
Dose in adults
Dose in adults :
- Give 0.25mg/kg (ref 1) (MAXIMUM of 25mg) as a single IV bolus over approximately 10 seconds
- See table below
- Benefit-risk of tenecteplase treatment should be carefully evaluated in patients weighing 50 kg or less due to limited availability of data
- 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
Metalyse 5000 units SPC Jan 2024
1: GUH, Acute stroke pathway version 1.4 Dec 2022
Therapeutic classification
Thrombolytic