Drug interactions
Apixaban + Tenecteplase
Severity: Major
Apixaban and Tenecteplase: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Tenecteplase is a thrombolytic, and apixaban is an anticoagulant that reduces clot formation. Together they markedly increase the risk of serious bleeding, including intracranial hemorrhage.
What this interaction means in plain words
Apixaban and Tenecteplase can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Apixaban belongs to Cardiovascular; Tenecteplase belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic effect of fibrinolysis and factor Xa inhibition.
What to do
Confirm the time of the last apixaban dose before giving thrombolysis, as recent use may preclude it. If the combination is unavoidable, monitor closely for bleeding.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Apixaban
- Apixaban + Dabigatran Contraindicated
- Apixaban + Defibrotide Contraindicated
- Apixaban + Edoxaban Contraindicated
- Apixaban + Ketorolac Contraindicated
- Apixaban + Mifepristone Contraindicated
- Abciximab + Apixaban Major
Other interactions of Tenecteplase
- Alteplase + Tenecteplase Contraindicated
- Acetylsalicylic acid + Tenecteplase Major
- Argatroban + Tenecteplase Major
- Dabigatran etexilate + Tenecteplase Major
- Dalteparin + Tenecteplase Major
- Diclofenac + Tenecteplase Major
Frequently asked questions
Can I take Apixaban with Tenecteplase?
MediHelp rates the interaction as major. Apixaban and Tenecteplase can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Tenecteplase is a thrombolytic, and apixaban is an anticoagulant that reduces clot formation. Together they markedly increase the risk of serious bleeding, including intracranial hemorrhage.
How serious is the interaction between Apixaban and Tenecteplase?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Confirm the time of the last apixaban dose before giving thrombolysis, as recent use may preclude it. If the combination is unavoidable, monitor closely for bleeding.
What other medicines interact with Apixaban?
MediHelp also lists interactions of Apixaban with, for example, Dabigatran, Defibrotide, Edoxaban. The full list is on the Apixaban page.
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