Stable Angina, Acute Coronary Syndromes and Fibrinolysis

Warning

Fibrinolytics

Specialist use only (S2)

TENECTEPLASE

ALTEPLASE

Prescribing Notes:

  • National Patient Safety Alert 2022: Shortage of alteplase and tenecteplase injections - update: supply situation of alteplase has improved. Tenecteplase anticipated re-supply date 27th December 2024.
  • Thrombolysis is most effective if given as soon as possible after acute myocardial infarction; urgent transfer to hospital is essential.
  • If severe bleeding occurs, the fibrinolytic should be discontinued; coagulation factors and/or tranexamic acid may be required.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.