tenecteplase (Rx)

Brand and Other Names:TNK tPA, TNKase
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 50mg
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Acute MI

Administer ASAP (within 30 minutes) after onset of acute MI

30-50 mg IV bolus over 5 sec once (based on weight)

  • <60 kg: 30 mg
  • 60-70 kg: 35 mg
  • 70-80 kg: 40 mg
  • 80-90 kg: 45 mg
  • >90 kg: 50 mg

Restore Function to Hemodialysis Catheters (Orphan)

Indicated to estore function to hemodialysis catheters

Orphan indication sponsor

  • Genentech, Inc; 1 DNA Way; South San Francisco, CA 94080-4990

Safety & efficacy not established

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Interactions

Interaction Checker

and tenecteplase

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Minor bleeding (22%)

            Frequency Not Defined

            Reperfusion arrhythmias

            MI

            Fever

            Nausea

            Vomiting

            Cholesterol embolization

            Allergic reaction

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            Warnings

            Contraindications

            Hypersensitivity

            Active bleeding, history of CVA, recent (within 2 months) intracranial or intraspinal surgery or trauma, intracranial neoplasm, AVM, aneurysm, bleeding diathesis, severe uncontrolled HTN, recent (within 3 mth) facial trauma, suspected aortic dissection

            See thrombolytic indications/contraindications

            Cautions

            Recent major surgery, cerebrovascular disease, recent GI or GU bleeding, HTN, acute pericarditis, subacute endocarditis, hemostatic defects, high likelihood of left heart thrombus, severe thrombophlebitis, severe hepatic/renal dysfunction, currently receiving oral anticoagulants, diabetic hemorrhagic retinopathy, elderly, recent admin of GP IIb/IIIa inhibitors

            Acute pericarditis, subacute endocarditis

            Ischemic Stroke: may have no benefit if used after 3 hr of onset

            Current use of warfarin and INR in high range may increase bleeding risk

            Monitor potential bleeding sites

            Cholesterol embolism reported

            Pregnancy or breastfeeding

            Adjuncts for MI treatment

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known whether drug crosses into breast milk, nursing not a priority in AMI

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Genetically engineered variant of alteplase with multiple point mutations of tPA molecule resulting in longer plasma half-life, enhanced fibrin specificity, & increased resistance to inactivation by plasminogen activator inhibitor 1 (PAI-1) compared to alteplase

            Promotes thrombolysis by converting plasminogen to plasmin which degrades fibrin & fibrinogen

            Pharmacokinetics

            Half-Life: 90-130 min

            Onset: 30 min

            Metabolism: Liver

            Metabolites: Degradation products (constituent amino acids of tenecteplase)

            Total Body Clearance: 99-119 mL/min

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            Administration

            IV Preparation

            Add 10 mL SWI to a 50 mg vial using TwinPak® device directing stream of diluent into powder. If foaming (usually slight) occurs, leave vial undisturbed for several minutes to allow dissipation of any large bubbles. Gently swirl (do not shake) until contents are completely dissolved.

            Do not discard shield assembly

            Use immediately or may be refrigerated up to 8 hr

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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