Abciximab
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
Tenecteplase
Fibrin-specific tissue plasminogen activator (recombinant, modified) · Thrombolytic
START
STEMI: single weight-banded IV bolus (30–50 mg over ~5 s) within time window, no contraindications; stroke 0.25 mg/kg (max 25 mg)
TYPICAL MAX
50 mg (STEMI); 25 mg (stroke)
STOP IF
Major bleeding (esp. intracranial — stop adjunct anticoagulant/antiplatelet, reverse), anaphylaxis
WATCH
Neuro status/bleeding, BP control before/after, weight-band dose accuracy, concomitant antithrombotics per protocol
CDSCO approvedATC B01AD11
KDIGO 2024 + manufacturer label
- ONSET
- 3min · fibrinolysis onset
- PEAK
- 5min · during bolus
- t½
- 21min · initial t½ (~22 min)
- DURATION
- 2h · lytic effect
EXCRETION
Hepatic catabolism; not renal
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Avoid except life-threatening — bleeding/placental risk; limited data
FDA category + note
Top interactionssee all 12 →
- AbciximabSevereDatabaseDDInter
- AcalabrutinibSevereDatabaseDDInter
- AnisindioneSevereDatabaseDDInter
- ApixabanSevereDatabaseDDInter
Available in India
7 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Bioengineered tPA variant with greater fibrin specificity, longer half-life (single-bolus dosing) and resistance to PAI-1; converts fibrin-bound plasminogen to plasmin, lysing the thrombus.
Indications
Acute ST-elevation myocardial infarction (when primary PCI not available within target time)Acute ischaemic stroke (within licensed window — increasingly used, region/protocol-dependent)Massive pulmonary embolism (off-label/selected)
Dosing
- Adult
- STEMI: single weight-based IV bolus over ~5 s — 30 mg (<60 kg) up to 50 mg (≥90 kg) (5 mg per 10 kg band). Ischaemic stroke: 0.25 mg/kg single bolus (max 25 mg) per protocol.
- Pediatric
- Not established (specialist).
- Renal adjustment
- No specific adjustment.
- Hepatic adjustment
- Caution in severe hepatic impairment (coagulopathy/bleeding).
- Geriatric
- Higher intracranial-haemorrhage risk; weigh benefit.
- Max dose
- 50 mg (STEMI weight-banded); stroke 25 mg
Pharmacokinetics
Onset
Fibrinolysis within minutes
Peak effect
During/after bolus
Duration
Lytic effect hours (less systemic fibrinogen depletion than streptokinase)
Half-life
Initial ~20–24 min; terminal ~90–130 min
Bioavailability
IV
Protein binding
Not applicable
Metabolism
Hepatic clearance
Excretion
Hepatic catabolism
Contraindications
- Active internal bleeding / bleeding diathesis
- Prior intracranial haemorrhage; recent ischaemic stroke (<3 months) or known intracranial neoplasm/AVM/aneurysm
- Recent major surgery/trauma/head injury (≤3 weeks)
- Severe uncontrolled hypertension
- Hypersensitivity to tenecteplase
Side effects
Common
Bleeding (puncture sites, GI, GU)HypotensionReperfusion arrhythmias (STEMI)Minor allergic reactions
Serious
- Major haemorrhage incl. intracranial (most feared)
- Anaphylaxis (rare; not antigenic like streptokinase)
- Cholesterol embolisation
- Severe reperfusion arrhythmia
Pregnancy & lactation
Pregnancy
Avoid except life-threatening — bleeding/placental risk; limited data
Lactation
Acute single use; brief interruption — limited data
Drug interactions
Acalabrutinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anisindione
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Apixaban
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Ardeparin
Severe
Database
Clinical effect not specified
Source: DDInter
Argatroban
Severe
Database
Clinical effect not specified
Source: DDInter
Avapritinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Betrixaban
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bivalirudin
Severe
Database
Clinical effect not specified
Source: DDInter
Cabozantinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Cangrelor
Severe
Database
Clinical effect not specified
Source: DDInter
Caplacizumab
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Ask House about Tenecteplase
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19