Indications and contraindications

Indications

Metalyse® is indicated for the thrombolytical treatment of suspected myocardial infarction with persistent ST elevation or recent left bundle branch block within 6 hours after the onset of acute myocardial infarction symptoms.1

Prescribing Information

Contraindications

Metalyse® is contraindicated in the following situations because thrombolytic therapy is associated with a higher risk of bleeding:1

  • Significant bleeding disorder either at present or within the past 6 months
  • Patients with current concomitant oral anticoagulant therapy (INR > 1.3)
  • Any history of central nervous system damage (i.e. neoplasm, aneurysm, intracranial or spinal surgery)
  • Known haemorrhagic diathesis
  • Severe uncontrolled hypertension
  • Major surgery, biopsy of a parenchymal organ, or significant trauma within the past 2 months
  • (this includes any trauma associated with the current AMI)
  • Recent trauma to the head or cranium
  • Prolonged cardiopulmonary resuscitation (> 2 minutes) within the past 2 weeks
  • Acute pericarditis and/or subacute bacterial endocarditis
  • Acute pancreatitis
  • Severe hepatic dysfunction, including hepatic failure, cirrhosis, portal hypertension (oesophageal varices) and active hepatitis
  • Active peptic ulceration
  • Arterial aneurysm and known arterial/venous malformation
  • Neoplasm with increased bleeding risk
  • Any known history of haemorrhagic stroke or stroke of unknown origin
  • Known history of ischaemic stroke or transient ischaemic attack in the preceding 6 months
  • Dementia
  • Hypersensitivity to the active substance tenecteplase and to any of the excipient
References: 
  1. Rawles J. Drugs 1995;50(4):615-625.
  2. Metalyse Prescribing Information
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