Tenecteplase, Injection

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KEY POINTS

• This medicine is given by IV to treat heart attacks by dissolving blood clots.
• This medicine increases your risk of bleeding. Be careful while shaving, cutting fingernails or toenails, or when using sharp objects. Check for blood in your urine or bowel movements.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: tissue plasminogen activator; thrombolytic

Generic and brand names: tenecteplase, injection; TNKase

What is this medicine used for?

This medicine is given by IV infusion (into a large vein) to treat heart attacks by dissolving blood clots.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A brain tumor or other brain disease
• A stroke or transient ischemic attack (TIA)
• Bleeding problems
• Blood vessel problems or blood clots
• Eye problems related to diabetes
• High blood pressure
• Liver or kidney disease
• Ulcers

Tell your healthcare provider if you have been injured, had an infection, had a baby, or had surgery in the last 2 months. Also tell your provider if you have recently taken a blood thinner.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine works best when given at the first symptoms of a heart attack. The infusions are usually given in a hospital.

You may also receive other medicines along with this medicine to help keep clots from forming.

What should I watch out for?

Receiving this treatment as soon as possible after you have symptoms of a heart attack improves your chances of recovery.

To help prevent serious bleeding, carefully follow the instructions given by your healthcare provider. Watch for signs of bleeding around your IV and check for blood in your urine or bowel movements. While you are receiving this medicine, your healthcare provider will carefully watch you for any serious side effects. Tell your healthcare provider right away if you notice any bleeding.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you have received this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Your healthcare provider will watch you closely to make sure the medicine is working and is not causing unwanted side effects. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Unusual bruising or bleeding, bloody or black tarry bowel movements; severe nausea, vomiting, stomach or back pain; blood in the urine; fast, slow, or irregular heartbeat; chest pain; blue or purple lips, fingers, or toes; decreased or trouble urinating; shortness of breath; severe joint or muscle pain.

Other: Mild nausea, fever, dizziness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alcohol
• Anagrelide (Agrylin)
• Antidepressants such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), levomilnacipran (Fetzima), sertraline (Zoloft), venlafaxine (Effexor), and vilazodone (Viibryd)
• Aspirin and other salicylates
• Medicines to treat or prevent blood clots such as abciximab (ReoPro), apixaban (Eliquis), cilostazol (Pletal), clopidogrel (Plavix), dabigatran (Pradaxa), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), eptifibatide (Integrilin), fondaparinux (Arixtra), heparin, prasugrel (Effient), rivaroxaban (Xarelto), ticagrelor (Brilinta), tirofiban (Aggrastat), and warfarin (Coumadin)
• Medicines to treat pulmonary hypertension such as epoprostenol (Flolan, Veletri), iloprost (Ventavis), and treprostinil (Remodulin, Tyvaso)
• Natural remedies such as alfalfa, bilberry, cat's claw, celery, chamomile, dong quai, evening primrose, fenugreek, feverfew, fish oil, garlic, ginger, ginkgo, ginseng, green tea, horse chestnut, licorice, red clover, turmeric, and willow
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), and sulindac (Clinoril)
• Paroxetine (Brisdelle, Paxil, Pexeva)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.