Ischaemic stroke

Formulary pathways for Ischaemic stroke are in the process of being updated in line with changes to national guidance. The recommendations presented here should be used in conjunction with your local Health Board guidance.

Thrombolysis
Tenecteplase
Tenecteplase 5,000unit powder for solution for injection vials

Alteplase is an alternative for use when tenecteplase is unsuitable due to hypersensitivity to the active substance, to any of the excipients, or to gentamicin (a trace residue from the manufacturing process).

Alteplase
Alteplase 10mg powder and solvent for solution for injection vials
Alteplase 20mg powder and solvent for solution for injection vials
Alteplase 50mg powder and solvent for solution for infusion vials

Prescribing Notes:

  • Thrombolytic treatments must be used in strict accordance with detailed protocols.
  • Different preparations for both alteplase and tenecteplase have different licensed indications.

History Notes

27/05/2026

Regional formulary chapter launched.

Treatment of ischaemic stroke

This formulary section is in development. Please refer to local stroke guidelines.


The medicine recommendations presented here are used in the treatment of fully resolved transient focal neurology symptoms suggestive of TIA, high-risk TIA and minor ischaemic stroke (NIHSS≤5), and moderate/severe ischaemic stroke. These medicines may be used alone, or in combination, in line with local guidance.

Aspirin
Aspirin 75mg dispersible tablets
Aspirin 300mg dispersible tablets
Clopidogrel
Clopidogrel 75mg tablets
Dipyridamole
Dipyridamole 200mg modified-release capsules

History Notes

27/05/2026

Regional formulary chapter launched.

Secondary prevention of ischaemic stroke

This formulary section is in development. Please refer to local stroke guidelines.

History Notes

27/05/2026

Regional formulary chapter launched.