From the Guidelines
Tenecteplase is administered as a single intravenous bolus, not as an infusion. According to the 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for the management of patients with acute coronary syndromes 1, the recommended dose of tenecteplase is a single IV weight-based bolus. The specific dosing is as follows:
- 30 mg for weight <60 kg
- 35 mg for 60-69 kg
- 40 mg for 70-79 kg
- 45 mg for 80-89 kg
- 50 mg for ≥90 kg This single-bolus administration is a significant advantage of tenecteplase, particularly in time-critical situations like ST-elevation myocardial infarction (STEMI), where rapid restoration of blood flow is essential. Unlike other thrombolytics such as alteplase (tPA), which requires a continuous infusion over 1-2 hours, tenecteplase's longer half-life and greater fibrin specificity allow for rapid single-bolus administration. Healthcare providers should monitor the patient closely for bleeding complications following administration, as with any thrombolytic therapy. Key benefits of tenecteplase include its rapid administration and high efficacy in restoring blood flow, making it a valuable option in acute coronary syndromes.
From the FDA Drug Label
TNKase is for intravenous administration only, administered as a single bolus over 5 seconds. The infusion time for tenecteplase is 5 seconds as it is administered as a single bolus 2.
From the Research
Tenecteplase Infusion Duration
- The duration of a tenecteplase infusion is not explicitly stated in the provided studies 3, 4, 5, 6, 7.
- However, it is mentioned that tenecteplase is typically administered as a single bolus 4, 5, 6, which suggests that the infusion duration is very short, usually around 5-10 seconds 6.
- In contrast, alteplase is administered as an intravenous bolus over 1 minute followed by an infusion over 1 hour 6, highlighting the difference in administration protocols between the two thrombolytic agents.
- The studies primarily focus on comparing the efficacy and safety of tenecteplase and alteplase in treating acute ischemic stroke, rather than detailing the specific infusion durations 3, 4, 5, 6, 7.