Table 2. Dosage of fibrinolytic and adjunctive antithrombotic agents.

Drug		Standard dosage	Comments
Fibrinolytic agents
	Tenecteplase	Single IV weight-based bolus	Fibrin specificity: strongest
		30 mg <60 kg	Patency rate 85%
		35 mg (7,000 IU) 60–69 kg	Age ≥75 years: 50% dose reduction
		40 mg 70–79 kg
		45 mg (9,000 IU) 80–89 kg
		50 mg ≥90 kg
	Reteplase	10 units+10 units	Fibrin specificity: less strong
		IV over 2 minutes (30 minutes apart)	Patency rate 84%
	Alteplase	15 mg IV bolus 1–2 minutes	Fibrin specificity: less strong
		0.75 mg/kg over 30 minutes	Patency rate 73–84%
		0.5 mg/kg over 60 minutes	Body weight >67 kg, 15 mg IV bolus, 50 mg over 30 minutes, 35 mg over 60 minutes
Antiplatelet agents
	Aspirin	150–300 mg loading, 75–100 mg maintain
	Clopidogrel	300 mg loading, 75 mg maintain	Age ≥75 years
				No loading, 75 mg maintain
Anticoagulation
	Enoxaparin	30 mg IV bolus	Age ≥75 years
		1 mg/kg SC every 12 hours (maximum 100 mg for the first 2 doses)		No bolus, 25% dose reduction
			eGFR <30 mL/min/1.73m2
				1 mg/kg every 24 hours
	UFH	60 IU/kg IV bolus (maximum 4,000 units)	No planned reperfusion
		12 IU/kg/hr (maximum 1,000 units/hr)		50–70 IU/kg IV bolus (maximum 5,000 IU)
		Target aPTT 1.5–2 times (approximately 50–70 seconds)		12 IU/kg/hr
				Target aPTT 1.5–2 times (approximately 50–70 seconds)

aPTT = activated partial thromboplastin time; eGFR = estimated glomerular filtration rate; IU = international units; IV = intravenous; SC = subcutaneous; UFH = unfractionated heparin.