Metalyse

What is it?

An antithrombotic agent which is a recombinant plasminogen activator, available as a powder in vials for reconstitution, containing 1000units of tenecteplase per ml (when made up), plus WFI in pre-prepared syringes.

Medical Uses

Patients with suspected heart attack when certain conditions apply, for thrombolytic treatment within 6 hours of episode.

Dosage

Adults, weighing under 60kg, 6,000 units; weighing 60 to 70kg, 7,000 units; weighing 70 to 80kg, 8,000 units; weighing 80 to 90kg, 9,000 units; weighing more than 90kg, 10,000 units. All given by intravenous bolus injection as a single dose over 10 seconds. Should be administered as soon as possible after onset of symptoms with heparin and aspirin. Also, consult manufacturer's literature.

Special Care

Only to be given under specialist supervision with monitoring facilities available. Pregnancy, breastfeeding, elderly patients, those of low body weight (less than 60kg), cerebrovascular disorders, bleeding, recent bleeding (within 10 days) in gastrointestinal or urinogenital tract, heart arrhythmias, systolic blood pressure greater than 160mm of mercury.

Avoid Use

Serious bleeding disorders or any condition with increased risk of bleeding, diabetic and haemorrhagic eye disease, haemorrhagic diathesis, recent major surgery or trauma, previous damage to central nervous system, severe high blood pressure which is not under control, acute pancreatitis, serious liver disorders, acute hepatitis, acute inflammation of pericardium (membrane around heart), bacterial endocarditis (inflammation and infection of the endocardium, the inner lining of the heart), aneurysm, known malformation of major arteries or veins, cardiopulmonary resuscitation within previous fortnight, dementia, previous stroke or transient ischaemic attack (TIA).

Possible Drug and Food Interactions

Drugs that affect blood platelets, anticoagulants taken by mouth.

Known Side Effects

Gastrointestinal upset, anaphylaxis, effects on heart and circulatory system, bleeding or haemorrhage. All adverse side effects should be reported to the Committee on the Safety of Medicines (CSM).