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Tenecteplase Side Effects

For the Consumer

Applies to tenecteplase: intravenous kit, intravenous powder for solution

Along with its needed effects, tenecteplase may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking tenecteplase:

More common
  • Bleeding or bruising of any kind, especially around the place of injection
  • collection of blood under skin
Less common or rare
  • Abdominal or stomach pain or swelling
  • back pain or backaches
  • blood in throat
  • blood in urine
  • bloody or black, tarry stools
  • constipation
  • cough
  • coughing up blood
  • difficulty swallowing
  • dizziness
  • fast, slow or irregular breathing
  • fast, slow or irregular heartbeat
  • headaches
  • hives
  • nosebleeds
  • shortness of breath and/or wheezing
  • skin rash, hives or itching
  • swelling of eyes, face, lips, or tongue
  • tightness in chest
  • unusual tiredness or weakness
  • vomiting of blood or material that looks like coffee grounds
  • wheezing

Some side effects of tenecteplase may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Bloody nose
  • unexplained nosebleeds

For Healthcare Professionals

Applies to tenecteplase: intravenous powder for injection


Major hematological side effects including hematoma (1.7%), gastrointestinal bleeding (>1%), urinary tract bleeding (<1%), puncture site bleeding (<1%), retroperitoneal bleeding (<1%), respiratory tract bleeding (<1%), and unspecified bleeding (<1%) have been reported. Intracranial hemorrhage (ICH) has also been reported. In one study, ICH occurred in 1%, 1.9%, and 3.8% of patients treated with 30, 40, and 50 mg of tenecteplase, respectively (patients were also receiving heparin).

Minor hematological side effects including hematoma (12.3%), urinary tract bleeding (3.7%), pharyngeal (3.1%), gastrointestinal tract bleeding (1.9%), epistaxis (1.5%), and unspecified bleeding (1.3%) have been reported.[Ref]


Cardiovascular side effects including cardiogenic shock, arrhythmias, atrioventricular block, heart failure, cardiac arrest, recurrent myocardial ischemia, myocardial reinfarction, myocardial rupture, cardiac tamponade, pericarditis, pericardial effusion, mitral regurgitation, thrombosis, electromechanical dissociation, and hypotension have been reported.[Ref]


Local side effects including bleeding from the puncture side have been reported.[Ref]


Respiratory side effects including pulmonary edema have been reported.[Ref]


1. Gibson CM, Marble SJ "Issues in the assessment of the safety and efficacy of tenecteplase (TNK-tPA)." Clin Cardiol 24 (2001): 577-84

2. Davydov L, Cheng JW "Tenecteplase: a review." Clin Ther 23 (2001): 982-97; discussion 981

3. "Product Information. TNKase (tenecteplase)" Genentech, South San Francisco, CA.

4. Turcasso NM, Nappi JM "Tenecteplase for treatment of acute myocardial infarction." Ann Pharmacother 35 (2001): 1233-40

5. Davydov L, Cheng JWM "Tenecteplase: A review." Clin Ther 23 (2001): 982-97

Some side effects of tenecteplase may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.