Administered on the basis of body wt. Max dose: 10,000 U (50 mg). Patient weighing ≥90 kg 50 mg, ≥80 to <90 kg 45 mg, ≥70 to <80 kg 40 mg, ≥60 to <70 kg 35 mg, <60 kg 30 mg. Given as a single IV bolus over 5-10 sec. Adjunctive therapy is recommended in patients w/ ST-elevation MI.
View Metalyse overdosage for action to be taken in the event of an overdose.
Contraindications
Hypersensitivity to tenecteplase or gentamicin. Significant bleeding disorder at present or w/in the past 6 mth, known haemorrhagic diathesis. Concomitant use w/ oral anticoagulant therapy (INR >1.3). History of CNS damage (ie, neoplasm, aneurysm, intracranial or spinal surgery). Severe uncontrolled arterial HTN. Major surgery, biopsy of a parenchymal organ or significant trauma w/in the past 2 mth, recent trauma to the head or cranium. Prolonged or traumatic CPR (>2 min) w/in the past 2 wk. Severe hepatic dysfunction including hepatic failure, cirrhosis, portal HTN (oesophageal varices) & active hepatitis. 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 (TIA) in the preceding 6 mth.
Discontinue use if anaphylactoid reaction occurs. Bleeding; concomitant use of heparin anticoagulation. Monitor all possible bleeding sites. Avoid use of rigid catheters, IM inj & non-essential handling of patient during therapy. Systolic BP >160 mmHg; recent GI or GUT bleeding; recent IM inj; advanced age ie, >75 yr; low body wt <60 kg; cerebrovascular disease; concomitant use w/ oral anticoagulant. Reperfusion arrhythmias. Concomitant use of GPIIb/IIIa antagonists; increased risk of thromboembolic events in patients w/ left heart thrombus eg, mitral stenosis or atrial fibrillation. Pregnancy & lactation.
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