Tenecteplase Half-Life
Tenecteplase has a terminal phase half-life of 90 to 130 minutes after intravenous bolus administration, which is substantially longer than alteplase and allows for convenient single-bolus dosing. 1, 2
Pharmacokinetic Profile
The half-life of tenecteplase is well-established across multiple authoritative sources:
- The FDA drug label confirms a terminal phase half-life of 90 to 130 minutes following IV bolus administration, with linear pharmacokinetics across the 30,40, and 50 mg dose range 2
- The American Heart Association recognizes this 90-130 minute half-life as the key pharmacokinetic feature that distinguishes tenecteplase from alteplase 1
- This extended half-life results from genetic modifications to the native tissue plasminogen activator molecule, including amino acid substitutions that provide approximately 14-fold greater fibrin specificity and slower plasma clearance 3
Clinical Significance of the Extended Half-Life
The longer half-life translates directly into practical clinical advantages:
- Single-bolus administration is possible (typically given over 5 seconds), eliminating the need for the 1-hour infusion required with alteplase 1, 4
- Workflow advantages are significant, particularly in centers considering endovascular therapy or patient transfer, as nursing time is reduced and potential medication errors are minimized 4
- The plasma clearance ranges from 99 to 119 mL/min, with liver metabolism serving as the major clearance mechanism 2
Comparison to Alteplase
The half-life difference between these agents is clinically meaningful:
- Alteplase requires continuous infusion over 60 minutes due to its shorter half-life (approximately 4-5 minutes for the initial phase) 4
- Tenecteplase's 90-130 minute half-life is approximately 18 minutes in some references, though the terminal elimination phase extends to the 90-130 minute range 3, 2
- Despite the longer half-life, tenecteplase maintains similar safety profiles to alteplase, with equivalent rates of symptomatic intracranial hemorrhage (1.2% in both groups) 5