Tenecteplase is a tissue plasminogen activator produced by recombinant DNA technology. It binds to fibrin and catalyzes the conversion of plasminogen to plasmin, which leads to rapid lysis of clots. Thrombolytic therapy with alteplase or tenecteplase is used in the treatment of myocardial infarction, ischemic stroke, and pulmonary embolism (PE). Alteplase is approved by the US Food and Drug Administration (FDA) for all 3 indications; tenecteplase is FDA approved only for the treatment of myocardial infarction. Many hospital systems are adding tenecteplase to the formulary or switching to tenecteplase as the thrombolytic of choice despite its lack of FDA approval for indications other than myocardial infarction. Institutions cite workflow advantages and potential cost savings with tenecteplase (the wholesale acquisition cost is $8071.39 per 50-mg vial of tenecteplase, as compared with $10560.43 per 100-mg vial of alteplase). Therefore, it is imperative for all clinicians involved with the treatment of patients with myocardial infarction, ischemic stroke, or PE to understand the pharmacology, uses, and clinical evidence regarding tenecteplase.
展开▼
