Tenecteplase Intravenous for Adults (Myocardial Infarction indication)

Who can administer

Doctor only

Important information

• This monograph refers to the use of tenecteplase for MYOCARDIAL INFARCTION. For use in STROKE - see separate monograph
• Should be used under guidance of senior cardiology physician
• Indicated for use within 6 hours after the onset of acute MI symptoms
• Tenecteplase should NOT BE ADMINISTERED in a line containing Glucose 5%

Available preparations

Metalyse 10,000 units (50mg) (vial with 50mg tenecteplase, and pre-filled syringe of 10ml solvent)

Metalyse 8,000 units (40mg) is NOT AVAILABLE in UHG

Reconstitution

• Check that the cap of the vial is still intact
• Remove the tip-cap from the syringe. Then immediately screw the pre-filled syringe on the vial adapter and penetrate the vial stopper in the middle with the spike of the vial adapter.
• Add the water for injections into the vial by pushing the syringe plunger down slowly to avoid foaming
• Reconstitute by swirling gently
• The reconstituted preparation results in a colourless to pale yellow, clear solution. Only clear solution without particles should be used
• Directly before the solution will be administered, invert the vial with the syringe still attached, so that the syringe is below the vial
• Transfer the appropriate volume of reconstituted solution of Metalyse into the syringe, based on the patient's weight
• Disconnect the syringe from the vial adapter
• Any unused solution should be discarded

Infusion fluids

• Not required

Methods of intravenous administration

Bolus intravenous injection

• Administer required dose over about 10 seconds

Dose in adults

Indication: Thrombolytic treatment of suspected myocardial infarction with persistent ST elevation or recent left Bundle Branch Block within 6 hours after the onset of acute myocardial infarction (AMI) symptoms.

Body weight (kg)	Tenecteplase (units)	Tenecteplase (mg)	Corresponding volume of reconstituted solution
less than 60kg	6,000 units	30mg	6ml
60kg to less than 70kg	7,000 units	35mg	7ml
70kg to less than 80kg	8,000 units	40mg	8ml
80kg to less than 90kg	9,000 units	45mg	9ml
90kg or more	10,000 units	50mg	10ml

Elderly patients

• Use with caution in patients 75 years or older, due to higher bleeding risk

Storage

Store below 25⁰C

References

SPC October 2017

Therapeutic classification

Thrombolytic agent