North East and North Cumbria
ICS Formulary
 
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2 Cardiovascular system
02-10-02 Fibrinolytic drugs

Primary Percutaneous Coronary Intervention (PCI) is now preferred to thrombolysis in patients with myocardial infarction with ST segment elevation (STEMI).


Streptokinase
First Choice

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Alteplase
Formulary
  • 10mg, 20mg, and 50mg injections.
  • Also approved for stoke in accordance with NICE guidance. 
  • 2mg in 2ml injection - approved for unblocking intravenous lines, mainly in paediatric dialysis patients.
Link  NICE NG128: Stroke and transient ischaemic attack in over 16s: diagnosis and initial management
Link  NICE TA264: Ischaemic stroke (acute) - alteplase

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Tenecteplase Metalyse®
Formulary
  • 5,000 units (25mg) powder and solvent for solution for injection
  • 10,000 units (50mg) powder and solvent for solution for injection
  • Approved or treating acute ischaemic stroke in adults in line with NICE
Link  NICE TA990: Tenecteplase for treating acute ischaemic stroke

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Urokinase
Formulary

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