Is Activase the same as tPA?

Medically reviewed by Carmen Pope, BPharm. Last updated on March 4, 2025.

Official answer

by Drugs.com

Yes, Activase is the same as tPA but technically tPA is an abbreviation for tissue plasminogen activator which is the drug class that encompasses all tissue plasminogen activators of which there are 3 that have been FDA approved in the United States, namely:

Activase (generic name alteplase)
Retavase (generic name reteplase)
TNKase (generic name Tenecteplase).

Sometimes healthcare professionals use "tPA" to refer to Activase because it was the first tissue plasminogen activator that was approved. But this may cause confusion and has been the reason behind dozens of medication errors.

The main issue is that Activase is indicated for managing acute myocardial infarction, acute ischemic stroke, and acute massive pulmonary embolism. Historically, the other tissue plasminogen activators —Retavase and TNKase—were indicated ONLY for managing acute myocardial infarction. However, it's important to note that in February 2025, the FDA approved TNKase (tenecteplase) for the treatment of acute ischemic stroke. Despite this new approval, TNKase is still not FDA-approved for pulmonary embolism, and Retavase remains approved only for acute myocardial infarction.

Errors often arise because of confusion between the abbreviation TNK and tPA, which has resulted in TNKase being given to stroke patients instead of the intended Activase. While TNKase is now approved for stroke treatment, dosing and administration protocols differ between the medications.

Because all three drugs—Activase, TNKase, and Retavase—are tissue plasminogen activators, referring to any one of these products as "tPA" may lead to confusion about the intended product. To avoid confusion, do not use the abbreviation tPA, instead write down exactly the name of the drug intended.

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