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Tenecteplase (TNK) Dosing for Ischemic Stroke Calculator

Weight-based tenecteplase dose for acute ischemic stroke.

Tenecteplase (TNK) Dosing for Ischemic Stroke Calculator
Weight
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When to use

  • Dosing IV tenecteplase as an alternative to alteplase in acute ischemic stroke, including before endovascular thrombectomy.

Formula

Dose = 0.25 mg/kg IV, single bolus, maximum 25 mg.

Pearls and pitfalls

  • The 0.25 mg/kg dose (EXTEND-IA TNK) showed reperfusion and functional outcomes at least as good as 0.4 mg/kg with fewer bleeding events in the dose-comparison trial.
  • Tenecteplase use for stroke remains off-label in many jurisdictions despite trial evidence.

References

  1. Campbell BCV, et al. N Engl J Med. 2018;378(17):1573-82.
  2. Campbell BCV, et al. JAMA. 2020;323(13):1257-65.