Tenecteplase use is restricted to indications for either:

(1) STEMI, or

(2) Acute ischemic stroke as replacement for alteplase with following criteria:

• • Patient has a diagnosis of acute ischemic stroke causing a neurological deficit and is 18 years of age or older
  • Time of symptom onset is within 4.5 hours of treatment
  • Recommended dose of 0.25 mg/kg (max dose: 25 mg) as a single bolus
  • No contraindications to thrombolytic therapy are present

Tenecteplase is non-formulary for treatment of pulmonary embolism; alteplase is available on formulary.

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