Contraindicated with allergy to tenecteplase; active internal bleeding; history of stroke; intracranial or intraspinal surgery or trauma (within 2 mo); intracranial neoplasm, arteriovenous malformation, or aneurysm; known bleeding diathesis; severe uncontrolled hypertension.

Use cautiously with recent major surgery, previous puncture of noncompressible vessels, cerebrovascular disease, recent GI or GU bleeding, recent trauma, hypertension, high likelihood of left heart thrombus, acute pericarditis, subacute bacterial endocarditis, hemostatic defects (including those secondary to severe hepatic or renal disease), severe hepatic impairment, pregnancy, diabetic hemorrhagic retinopathy or other hemorrhagic ophthalmic conditions, septic thrombophlebitis or occluded AV cannula at seriously infected site, advanced age, patients currently receiving oral anticoagulants, recent use of GP IIb/IIIa inhibitors,
any other condition in which bleeding constitutes a significant hazard or would be particularly difficult to manage because of its location.