Drug interactions
Enoxaparin + Tenecteplase
Severity: Major
Enoxaparin and Tenecteplase: major interaction.
Last updated Sources: UK SmPC
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 fibrin-specific thrombolytic, and giving it with enoxaparin raises the risk of major bleeding, including intracranial hemorrhage. The combination is used in acute coronary syndromes under protocols but carries real hemorrhagic risk.
What this interaction means in plain words
Enoxaparin 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.
Enoxaparin belongs to Cardiovascular; Tenecteplase belongs to Cardiovascular.
Why it happens
Additive effects of fibrinolysis from tenecteplase and anticoagulation from enoxaparin.
What to do
Use only under a defined protocol with appropriate enoxaparin dosing, with dose reduction in older adults and in renal impairment. Monitor for bleeding and avoid invasive procedures.
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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References
- Inhixa 10,000 IU (100 mg) in 1.0 mL solution for injection in pre-filled syringe - SmPC sections 4.3/4.5 (names the partner; "es, acetylsalicylic acid at anti-inflammatory doses, and NSAIDs including ketorolac, - Other thrombolytics (e.g. alteplase, reteplase, streptokinase, tenectepla") — electronic medicines compendium (UK SmPC)
Other interactions of Enoxaparin
- Defibrotide + Enoxaparin Contraindicated
- Enoxaparin + Ketorolac Contraindicated
- Enoxaparin + Mifepristone Contraindicated
- Abciximab + Enoxaparin Major
- Aceclofenac + Enoxaparin Major
- Acetylsalicylic acid + Enoxaparin Major
Other interactions of Tenecteplase
- Alteplase + Tenecteplase Contraindicated
- Acetylsalicylic acid + Tenecteplase Major
- Apixaban + Tenecteplase Major
- Argatroban + Tenecteplase Major
- Dabigatran etexilate + Tenecteplase Major
- Dalteparin + Tenecteplase Major
Frequently asked questions
Can I take Enoxaparin with Tenecteplase?
MediHelp rates the interaction as major. Enoxaparin 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 fibrin-specific thrombolytic, and giving it with enoxaparin raises the risk of major bleeding, including intracranial hemorrhage. The combination is used in acute coronary syndromes under protocols but carries real hemorrhagic risk.
How serious is the interaction between Enoxaparin 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: Use only under a defined protocol with appropriate enoxaparin dosing, with dose reduction in older adults and in renal impairment. Monitor for bleeding and avoid invasive procedures.
What other medicines interact with Enoxaparin?
MediHelp also lists interactions of Enoxaparin with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Enoxaparin page.
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