FAQs on Tenecteplase vs Alteplase: A Head-to-Head in Acute Ischemic Stroke
1. Which specialist doctor to consult for Acute ischemic stroke?For acute ischemic stroke, it's essential to consult a neurologist, as they specialize in conditions affecting the nervous system, including strokes. In emergency situations, you may initially see an emergency medicine physician.
2. Why is alteplase contraindicated in ischemic stroke?
Alteplase is contraindicated in ischemic stroke due to risks of serious complications like intracranial hemorrhage. Key contraindications include recent hemorrhage, severe hypertension, active bleeding, recent surgery or trauma, known allergies to alteplase, and certain medical conditions that increase bleeding risk, ensuring patient safety during treatment.
3. Why is tenecteplase preferred over alteplase?
Tenecteplase is favored for its easier administration as a single IV bolus, longer half-life, and greater fibrin specificity. Initial studies indicate it may provide comparable or enhanced efficacy to alteplase, especially in cases of acute ischemic stroke.
4. What is the tenecteplase dosing for acute ischemic stroke?
The recommended dosing for tenecteplase in acute ischemic stroke is typically 0.25 mg/kg, administered as a single intravenous bolus, with a maximum dose of 25 mg. It should be given as soon as possible after the onset of symptoms, ideally within a 4.5-hour window.
5. Is tenecteplase cheaper than alteplase?
Yes, tenecteplase is generally considered to be less expensive than alteplase. The lower cost of tenecteplase may be due to its simpler dosing regimen (a single bolus) and potential for reduced hospital resource utilization.
6. What is the window period for tenecteplase?
The window period for administering tenecteplase in acute ischemic stroke is typically within 4.5 hours of symptom onset.
7. Can tenecteplase be used in elderly patients?
Yes, tenecteplase can be used in elderly patients, but careful assessment of risks is essential.
8. Is tenecteplase effective for large vessel occlusions?
Early studies suggest tenecteplase may be effective for large vessel occlusions, but further research is needed.
9. What is the recommended dosing for alteplase in stroke?
For acute ischemic stroke, the recommended dose is 0.9 mg/kg, with a maximum dose of 90 mg.
10. Is alteplase effective for chronic ischemic conditions?
Alteplase is primarily effective for acute thrombotic events and is not indicated for chronic ischemic conditions.
