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Tenecteplase Side Effects

Medically reviewed by Last updated on Jun 11, 2022.

For the Consumer

Applies to tenecteplase: intravenous powder for solution

Side effects requiring immediate medical attention

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

Side effects not requiring immediate medical attention

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 kit, 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]

Frequently asked questions


1. "Product Information. TNKase (tenecteplase)." Genentech (2001):

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

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

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

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

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.