Thrombolytics for Acute Ischemic Stroke: Conversion from Alteplase to Tenecteplase

For Providers, Nurses and Pharmacists

Effective Tuesday, May 16, HM is switching from alteplase (Activase®) to tenecteplase (TNKase®) for acute ischemic stroke. Tenecteplase has been shown to have similar or better efficacy and safety compared to alteplase with the added benefit of a simpler administration process.

Name changes you may notice, in Epic or across our systems, include:

• Stroke Alteplase Orders will now be Stroke Tenecteplase Orders

• Alteplase (tPA)-Associated Angioedema Management will now be Thrombolytic-Associated Angioedema Management

• Alteplase (tPA) Reversal Management – Symptomatic ICH Management within 24 Hours of alteplase (tPA) Administration will now be Thrombolytic Reversal Management – Symptomatic ICH Management within 24 Hours of Thrombolytic Administration

To avoid confusion, and as recommended by the Institute for Safe Medication Practices, the term tPA will be eliminated from all sources (e.g., Epic, Pyxis, etc.). Instead, the words tenecteplase, alteplase or thrombolytic will be used when applicable.

For questions email druginfo@houstonmethodist.org