Actilyse vs Metalyse: Side-by-Side Comparison
Quick answer: Actilyse and Metalyse are both thrombolytic (tissue plasminogen activator) used for similar indications. They share a mechanism of action but differ in dosing, half-life, side-effect profile, and clinical preferences. Switching between them is a clinical decision.
Side-by-side comparison
| Feature | Actilyse | Metalyse |
|---|---|---|
| Drug class | Thrombolytic (tissue plasminogen activator) | Thrombolytic (tissue plasminogen activator) |
| ATC code | B01AD02 | B01AD11 |
| Primary indications | Acute ischemic stroke, Acute myocardial infarction | Acute myocardial infarction (STEMI), Acute ischemic stroke |
| Mechanism | Recombinant tPA converting plasminogen to plasmin to dissolve fibrin clots | Recombinant fibrin-specific plasminogen activator (tenecteplase) that converts plasminogen to plasmin to dissolve fibrin clots |
| Common dose | 0.9 mg/kg IV (max 90 mg) for stroke | Single weight-based IV bolus (30-50 mg) |
| Detail page | Actilyse details → | Metalyse details → |
How to choose between Actilyse and Metalyse
Both medicines belong to the same therapeutic class and address overlapping indications. Selection between them depends on:
- Patient-specific factors: age, kidney and liver function, other medications, allergies, comorbidities
- Specific clinical indication: some class members are preferred for particular conditions or guideline recommendations
- Dosing preference: once-daily vs twice-daily, oral vs injectable, food requirements
- Tolerability: individual side-effect profiles vary even within a class
- Drug interactions: patient's other medications may interact differently with each option
- Cost and availability: generic availability, insurance coverage, regional access
Should you switch?
Switching between class members is a clinical decision, not a self-help one. Reasons your prescriber may consider switching include:
- Inadequate response to current medication
- Side effects affecting quality of life
- New drug interactions due to a recently added medication
- Cost or availability changes
- Updated guidelines favoring a different option
Never switch medications, change dose, or stop without consulting your prescriber.
Related
All Thrombolytic (tissue plasminogen activator) on iMedic · Actilyse full details · Metalyse full details
Frequently asked questions
Is Actilyse better than Metalyse?
Neither is universally 'better.' They are both thrombolytic (tissue plasminogen activator) with similar mechanisms of action. The right choice depends on the specific clinical situation, patient factors, dosing preferences, drug interactions, and tolerability. Discuss with your prescriber.
Can I switch from Actilyse to Metalyse?
Switching is possible but should be done under clinical supervision. Different class members may not be interchangeable on a 1:1 dose basis, and tapering or transition strategies vary. Never switch on your own.
Do Actilyse and Metalyse have the same side effects?
They share class-wide side-effect tendencies but differ in individual profiles. Some patients tolerate one better than the other. Specific frequency and severity of side effects can be found on each medicine's individual page.
Are Actilyse and Metalyse available as generics?
Generic availability depends on patent status in your country. Most well-established class members are available generically and are clinically equivalent to brand-name versions.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.