Tenecteplase is in a group of drugs called tissue plasminogen activators (TPAs). It works by causing the body to over-produce a substance called plasmin to dissolve unwanted blood clots.

Tenecteplase is used to prevent death from a heart attack (acute myocardial infarction).

Tenecteplase may also be used for other purposes not listed in this medication guide.

You should not receive this medication if you have internal bleeding, brain cancer or aneurysm, a history of stroke, a bleeding or blood clotting disorder, or if you have had brain or spinal cord injury or surgery within the past 2 months.

Before you are treated with tenecteplase, tell your doctor if you have a blood vessel disorder of the eye, severe liver or kidney disease, high blood pressure, an infection of the lining of your heart (also called bacterial endocarditis), a recent history of stomach or urinary bleeding, if you have recently had a baby, or if you have recently had a serious injury or major surgery.

Also tell your doctor if you take a blood thinner such as warfarin (Coumadin), or other medications to treat or prevent blood clots.

Tell your caregivers at once if you have a serious side effect such as blood in your urine or stools, nosebleed, coughing up blood, bleeding from a skin wound or the IV needle, fast or slow heart rate, or feeling like you might pass out.

Tenecteplase may cause rare but serious side effects such as: purple discoloration of your legs or toes, sudden numbness or weakness, problems with vision or speech, chest pain or heavy feeling, urinating less than usual or not at all, muscle pain or tenderness, dark colored urine, unusual sensations in your back, numbness or tingling in your legs or feet, muscle weakness or loss of use, or loss of bowel or bladder control.

Tenecteplase can cause you to have unusual results with blood tests. Tell any doctor who treats you that you have recently received tenecteplase.

You should not receive this medication if you have:

• internal bleeding;

• a history of stroke;

• brain cancer;

• brain aneurysm;

• a bleeding or blood clotting disorder (such as hemophilia); or

• if you have had brain or spinal cord injury or surgery within the past 2 months.

If you have certain conditions, you may need a dose adjustment or special tests to safely receive this medication. Before you receive tenecteplase, tell your doctor if you have:

• a blood vessel disorder of the eye;

• severe liver or kidney disease;

• high blood pressure;

• an infection of the lining of your heart (also called bacterial endocarditis);

• a recent history of bleeding in your stomach, intestines, or urinary tract;

• if you have recently had a baby; or

• if you have recently had a serious injury or major surgery.

FDA pregnancy category C. Tenecteplase may be harmful to an unborn baby. Before you receive this medication, tell your doctor if you are pregnant.

It is not known whether tenecteplase passes into breast milk or if it could harm a nursing baby. Before you receive this medication , tell your doctor if you are breast-feeding a baby.