Follow the instructions to properly reconstitute and administer TNkase for AMI.

• Reconstitution Instructions for TNKase
• Administration Instructions for TNKase

Reconstitution Instructions for TNKase

See TNKase Package Insert for instructions on the use of the dual cannula device.

Step 2	Aseptically WITHDRAW 10 mL of Sterile Water for Injection, USP, using the B-D 10 mL syringe with TwinPakTM Dual Cannula Device included in the kit. Do not use Bacteriostatic Water for Injection, USP.
Step 3	INJECT entire contents (10 mL) into the TNKase vial, directing the diluent into the powder. Slight foaming upon reconstitution is not unusual; any large bubbles will dissipate if the product is allowed to stand undisturbed for several minutes.
Step 4	GENTLY SWIRL until contents are completely dissolved. DO NOT SHAKE. Solution should be colorless or pale yellow and transparent. Once the appropriate dose of TNKase is drawn into the syringe, stand the shield vertically and recap the red tab cannula.
Step 5	USE UPON RECONSTITUTION. If not used immediately, refrigerate solution (which does not contain bacterial preservative) at 2–8°C (36–46°F) and use within 8 hours. DO NOT FREEZE. Final concentration of TNKase is 5 mg/mL.

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Administration Instructions for TNKase

Step 1	Determine the correct dose of TNKase based on patient weight. TNKase is for IV administration only.

Step 2	WITHDRAW the appropriate volume of solution based on patient weight. The recommended total dose should not exceed 50 mg. Discard solution remaining in the vial.
Step 3	FLUSH a dextrose-containing line with a saline-containing solution prior to and following administration (precipitation may occur when TNKase is administered in an IV line containing dextrose). ADMINISTER as an IV BOLUS over 5 seconds.

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Indication:
For use in mortality reduction associated with acute myocardial infarction (AMI). Treatment should be initiated as soon as possible after the onset of AMI symptoms.

Important Safety Information:
TNKase therapy in patients with acute myocardial infarction is contraindicated in the following certain situations (eg, active internal bleeding, history of cerebrovascular accident, known bleeding diathesis, severe uncontrolled hypertension) because of an increased risk of bleeding [See CONTRAINDICATIONS in full prescribing information].

The most common complication encountered during TNKase therapy is bleeding. Should serious bleeding (not controlled by local pressure) occur, any concomitant heparin or antiplatelet agents should be discontinued immediately.

In certain conditions (eg, recent major surgery, cerebrovascular disease, hypertension) the risk of TNKase therapy may be increased and should be weighed against the anticipated benefits. [See WARNINGS in full prescribing information].

Cholesterol embolism has been reported rarely in patients treated with all types of thrombolytic agents; the true incidence is unknown.

Coronary thrombolysis may result in arrhythmias associated with reperfusion. It is recommended that anti-arrhythmic therapy for bradycardia and/or ventricular irritability be available when TNKase is administered.

Please see full prescribing information for additional important safety information.