Before Receiving This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For tenecteplase, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to tenecteplase. Also tell your doctor and pharmacist if you are allergic to any other substances.

Pregnancy—Tenecteplase has not been studied in pregnant women. However, studies in rabbits have shown that multiple intravenous administrations of tenecteplase cause maternal and embryo toxicity, but no fetal abnormalities have been observed. Tenecteplase does not cause maternal and embryo toxicity in rabbits after a single intravenous administration. Before taking this medicine, make sure your doctor knows if you are pregnant or if you have recently had a baby.

The most common adverse effect of tenecteplase therapy is bleeding, and pregnancy can increase this risk.

Breast-feeding— It is not known whether tenecteplase passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who have been given this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of tenecteplase in children with use in other age groups.

Older adults—The need for treatment with tenecteplase may be increased in elderly patients with blood clots. However, the chance of bleeding may also be increased. It is especially important that you discuss the use of this medicine with your doctor.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Before you receive tenecteplase, it is especially important that your doctor know if you are taking any of the following:

• Anticoagulants (blood thinners) or
• Aspirin or
• Clopidogrel (e.g., Plavix)
• Dipyridamole (e.g., Persantine) or
• Heparin or
• Ticlopidine (e.g., Ticlid) or
• Warfarin (e.g., Coumadin)—The chance of bleeding may be increased

Other medical problems—Other medical problems or recent childbirth. The presence of other medical problems or recent delivery of a child may affect the use of tenecteplase. Make sure you tell your doctor if you have any other medical problems, especially:

• Blood disease, bleeding problems, or a history of bleeding in any part of the body or
• Brain disease or tumor or
• Heart or blood vessel disease, including irregular heartbeat or
• High blood pressure or
• Liver disease or
• Stroke—The chance of bleeding may be increased

• Infection—Chance of spreading the infection into the blood stream

Also, tell your doctor if you have recently had any of the following conditions:

• Falls or blow to the body or head or any other injury or
• Injections into a blood vessel or
• Placement of any tube into the body or
• Surgery of any kind, including dental surgery—The chance of serious bleeding may be increased

If you have recently had a baby, use of this medicine may cause serious bleeding.