Potential in vitro interaction between tenecteplase and unfractionated heparin.
OBJECTIVE
To explore the potential of a direct drug interaction between unfractionated heparin (UFH) and tenecteplase that lowers the pharmacologic propensity of UFH to prolong the activated partial thromboplastin time (aPTT).


METHODS
In vitro experiment.


METHODS
Texas Tech University School of Pharmacy, with sample analysis performed at an independent, contract laboratory. Samples. Blood samples collected from healthy volunteers.


METHODS
Three separate in vitro experiments were conducted to explore the relative influence of various thrombolytic agents with and without UFH on aPTT prolongation. In each experiment, blood from healthy volunteers (12 for each experiment) was treated with different concentrations and combinations of tenecteplase and UFH.


RESULTS
When the effects of tenecteplase plus UFH versus UFH alone on aPTT prolongation were compared, each experiment demonstrated attenuation of aPTT with the combination versus UFH alone. In contrast, findings for other thrombolytic agents combined with UFH demonstrate elevation of the aPTT compared with UFH alone.


CONCLUSIONS
The results indicate a possible drug interaction between tenecteplase and UFH, with tenecteplase attenuating the intensity of anticoagulation of UFH in vitro. Further investigation into this possible interaction is warranted in the clinical setting.
Tsikouris
James P
JP
Schools of Pharmacy, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA. james.tsikouris@ttuhsc.edu
Martin
Christopher P
CP
Cox
Craig D
CD
Ziska
Martin
M
Suarez
Jose A
JA
Meyerrose
Gary E
GE
D004347:Drug Interactions; D005340:Fibrinogen / Q000187:drug effects*; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D006493:Heparin / Q000494:pharmacology*; D006801:Humans; D066298:In Vitro Techniques; D010314:Partial Thromboplastin Time; D000077785:Tenecteplase; D010959:Tissue Plasminogen Activator / Q000494:pharmacology*
D005343:Fibrinolytic Agents; D005340:Fibrinogen; D006493:Heparin; D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase