Details of the Drug

General Information of Drug (ID: DMJYN25)

• Drug Name: Tenecteplase
• Synonyms: Tnkase; Tnkase (TN); Tenecteplase (USAN/INN)

Indication

Disease Entry	ICD 11	Status	REF
Acute myocardial infarction	BA41	Approved	[1]
Myocardial infarction	BA41-BA43	Approved	[2]
Pulmonary embolism	BB00	Approved	[3]

• Therapeutic Class: Thrombolytic Agents
• Sequence:
  SYQVICRDEKTQMIYQQHQSWLRPVLRSNRVEYCWCNSGRAQCHSVPVKSCSEPRCFNGG
  TCQQALYFSDFVCQCPEGFAGKCCEIDTRATCYEDQGISYRGNWSTAESGAECTNWQSSA
  LAQKPYSGRRPDAIRLGLGNHNYCRNPDRDSKPWCYVFKAGKYSSEFCSTPACSEGNSDC
  YFGNGSAYRGTHSLTESGASCLPWNSMILIGKVYTAQNPSAQALGLGKHNYCRNPDGDAK
  PWCHVLKNRRLTWEYCDVPSCSTCGLRQYSQPQFRIKGGLFADIASHPWQAAIFAAAAAS
  PGERFLCGGILISSCWILSAAHCFQERFPPHHLTVILGRTYRVVPGEEEQKFEVEKYIVH
  KEFDDDTYDNDIALLQLKSDSSRCAQESSVVRTVCLPPADLQLPDWTECELSGYGKHEAL
  SPFYSERLKEAHVRLYPSSRCTSQHLLNRTVTDNMLCAGDTRSGGPQANLHDACQGDSGG
  PLVCLNDGRMTLVGIISWGLGCGQKDVPGVYTKVTNYLDWIRDNMRP
• ADMET Property: Half-life: The concentration or amount of drug in body reduced by one-half in 1.9 hours (in mammalian reticulocytes) [4]
• Cross-matching ID:
  DrugBank ID: DB00031
  TTD ID: D0FX8A
• Repurposed Drugs (RPD): Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Plasminogen (PLG)	TTP86E2	PLMN_HUMAN	Activator	[5]

Molecular Expression Atlas of This Drug

• The Studied Disease: Acute myocardial infarction
• ICD Disease Classification: BA41

Molecule Name	Molecule Type	Gene Name	p-value	Fold-Change	Z-score
Plasminogen (PLG)	DTT	PLG	8.61E-01	-0.01	-0.09

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Tenecteplase

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Disease	REF
Prasugrel	DM7MT6E	Major	Increased risk of bleeding by the combination of Tenecteplase and Prasugrel.	Myocardial infarction [BA41-BA43]	[6]
Vorapaxar	DMA16BR	Major	Increased risk of bleeding by the combination of Tenecteplase and Vorapaxar.	Myocardial infarction [BA41-BA43]	[7]

Coadministration of a Drug Treating the Disease Different from Tenecteplase (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Cilostazol	DMZMSCT	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Cilostazol.	Arterial occlusive disease [BD40]	[8]
Pentosan polysulfate	DM2HRKE	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Pentosan polysulfate.	Chronic pain [MG30]	[9]
Phenylbutazone	DMAYL0T	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Phenylbutazone.	Chronic pain [MG30]	[10]
Ketoprofen	DMRKXPT	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Ketoprofen.	Chronic pain [MG30]	[10]
Levomilnacipran	DMV26S8	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Levomilnacipran.	Chronic pain [MG30]	[11]
Anisindione	DM2C48U	Major	Increased risk of bleeding by the combination of Tenecteplase and Anisindione.	Coagulation defect [3B10]	[12]
Regorafenib	DMHSY1I	Major	Increased risk of bleeding by the combination of Tenecteplase and Regorafenib.	Colorectal cancer [2B91]	[6]
Ardeparin	DMYRX8B	Major	Increased risk of bleeding by the combination of Tenecteplase and Ardeparin.	Coronary thrombosis [BA43]	[13]
Danaparoid	DM6CLBN	Major	Increased risk of bleeding by the combination of Tenecteplase and Danaparoid.	Deep vein thrombosis [BD71]	[13]
Rivaroxaban	DMQMBZ1	Major	Increased risk of bleeding by the combination of Tenecteplase and Rivaroxaban.	Deep vein thrombosis [BD71]	[14]
Sertraline	DM0FB1J	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Sertraline.	Depression [6A70-6A7Z]	[11]
Fluoxetine	DM3PD2C	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Fluoxetine.	Depression [6A70-6A7Z]	[11]
Vilazodone	DM4LECQ	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Vilazodone.	Depression [6A70-6A7Z]	[11]
Paroxetine	DM5PVQE	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Paroxetine.	Depression [6A70-6A7Z]	[11]
Vortioxetine	DM6F1PU	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Vortioxetine.	Depression [6A70-6A7Z]	[11]
Duloxetine	DM9BI7M	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Duloxetine.	Depression [6A70-6A7Z]	[11]
Milnacipran	DMBFE74	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Milnacipran.	Depression [6A70-6A7Z]	[11]
Escitalopram	DMFK9HG	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Escitalopram.	Depression [6A70-6A7Z]	[11]
Desvenlafaxine	DMHD4PE	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Desvenlafaxine.	Depression [6A70-6A7Z]	[11]
Clomipramine	DMINRKW	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Clomipramine.	Depression [6A70-6A7Z]	[11]
Fluvoxamine	DMQTJSX	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Fluvoxamine.	Depression [6A70-6A7Z]	[11]
Venlafaxine	DMR6QH0	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Venlafaxine.	Depression [6A70-6A7Z]	[11]
Heme	DMGC287	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Heme.	Discovery agent [N.A.]	[15]
Apigenin	DMI3491	Minor	Increased risk of bleeding by the combination of Tenecteplase and Apigenin.	Discovery agent [N.A.]	[16]
Citalopram derivative 1	DMITX1G	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Citalopram derivative 1.	Discovery agent [N.A.]	[11]
PMID28870136-Compound-49	DMTUC9E	Moderate	Increased risk of bleeding by the combination of Tenecteplase and PMID28870136-Compound-49.	Discovery agent [N.A.]	[17]
Fenfluramine	DM0762O	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Fenfluramine.	Epilepsy/seizure [8A61-8A6Z]	[11]
Mefenamic acid	DMK7HFI	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Mefenamic acid.	Female pelvic pain [GA34]	[10]
Avapritinib	DMK2GZX	Major	Increased risk of bleeding by the combination of Tenecteplase and Avapritinib.	Gastrointestinal stromal tumour [2B5B]	[6]
Sulfinpyrazone	DMEV954	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Sulfinpyrazone.	Gout [FA25]	[8]
Tipranavir	DM8HJX6	Major	Increased risk of bleeding by the combination of Tenecteplase and Tipranavir.	Human immunodeficiency virus disease [1C60-1C62]	[18]
Moexipril	DM26E4B	Moderate	Increased risk of angioedema by the combination of Tenecteplase and Moexipril.	Hypertension [BA00-BA04]	[19]
Captopril	DM458UM	Moderate	Increased risk of angioedema by the combination of Tenecteplase and Captopril.	Hypertension [BA00-BA04]	[19]
Trandolapril	DM4L6EU	Moderate	Increased risk of angioedema by the combination of Tenecteplase and Trandolapril.	Hypertension [BA00-BA04]	[19]
Fosinopril	DM9NJ52	Moderate	Increased risk of angioedema by the combination of Tenecteplase and Fosinopril.	Hypertension [BA00-BA04]	[19]
Enalapril	DMNFUZR	Moderate	Increased risk of angioedema by the combination of Tenecteplase and Enalapril.	Hypertension [BA00-BA04]	[19]
Perindopril	DMOPZDT	Moderate	Increased risk of angioedema by the combination of Tenecteplase and Perindopril.	Hypertension [BA00-BA04]	[19]
Quinapril	DMR8H31	Moderate	Increased risk of angioedema by the combination of Tenecteplase and Quinapril.	Hypertension [BA00-BA04]	[19]
Lisinopril	DMUOK4C	Moderate	Increased risk of angioedema by the combination of Tenecteplase and Lisinopril.	Hypertension [BA00-BA04]	[19]
Meclofenamic acid	DM05FXR	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Meclofenamic acid.	Inflammatory spondyloarthritis [FA92]	[10]
Ticlopidine	DMO946V	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Ticlopidine.	Ischaemic/haemorrhagic stroke [8B20]	[8]
Tositumomab	DMMYZ3D	Major	Increased risk of bleeding by the combination of Tenecteplase and Tositumomab.	Malignant haematopoietic neoplasm [2B33]	[20]
Acalabrutinib	DM7GCVW	Major	Increased risk of bleeding by the combination of Tenecteplase and Acalabrutinib.	Mature B-cell lymphoma [2A85]	[21]
Ibrutinib	DMHZCPO	Major	Increased risk of bleeding by the combination of Tenecteplase and Ibrutinib.	Mature B-cell lymphoma [2A85]	[22]
Ponatinib	DMYGJQO	Major	Increased risk of bleeding by the combination of Tenecteplase and Ponatinib.	Mature B-cell lymphoma [2A85]	[23]
Dasatinib	DMJV2EK	Major	Increased risk of bleeding by the combination of Tenecteplase and Dasatinib.	Myeloproliferative neoplasm [2A20]	[24]
Sibutramine	DMFJTDI	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Sibutramine.	Obesity [5B80-5B81]	[11]
Dexfenfluramine	DMJ7YDS	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Dexfenfluramine.	Obesity [5B80-5B81]	[11]
Diclofenac	DMPIHLS	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Diclofenac.	Osteoarthritis [FA00-FA05]	[10]
Nepafenac	DMYK490	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Nepafenac.	Osteoarthritis [FA00-FA05]	[10]
Naproxen	DMZ5RGV	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Naproxen.	Osteoarthritis [FA00-FA05]	[10]
MK-4827	DMLYGH4	Moderate	Increased risk of bleeding by the combination of Tenecteplase and MK-4827.	Ovarian cancer [2C73]	[6]
Aspirin	DM672AH	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Aspirin.	Pain [MG30-MG3Z]	[8]
Etodolac	DM6WJO9	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Etodolac.	Pain [MG30-MG3Z]	[10]
Diflunisal	DM7EN8I	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Diflunisal.	Pain [MG30-MG3Z]	[8]
Ibuprofen	DM8VCBE	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Ibuprofen.	Pain [MG30-MG3Z]	[10]
Nabumetone	DMAT2XH	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Nabumetone.	Pain [MG30-MG3Z]	[10]
Piroxicam	DMTK234	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Piroxicam.	Pain [MG30-MG3Z]	[10]
Choline salicylate	DM8P137	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Choline salicylate.	Postoperative inflammation [1A00-CA43]	[8]
Ketorolac	DMI4EL5	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Ketorolac.	Postoperative inflammation [1A00-CA43]	[10]
Bromfenac	DMKB79O	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Bromfenac.	Postoperative inflammation [1A00-CA43]	[10]
Treprostinil	DMTIQF3	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Treprostinil.	Pulmonary hypertension [BB01]	[8]
Epoprostenol	DMUTYR2	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Epoprostenol.	Pulmonary hypertension [BB01]	[8]
Iloprost	DMVPZBE	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Iloprost.	Pulmonary hypertension [BB01]	[8]
Salsalate	DM13P4C	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Salsalate.	Rheumatoid arthritis [FA20]	[8]
Meloxicam	DM2AR7L	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Meloxicam.	Rheumatoid arthritis [FA20]	[10]
Sulindac	DM2QHZU	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Sulindac.	Rheumatoid arthritis [FA20]	[10]
Oxaprozin	DM9UB0P	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Oxaprozin.	Rheumatoid arthritis [FA20]	[10]
Flurbiprofen	DMGN4BY	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Flurbiprofen.	Rheumatoid arthritis [FA20]	[10]
Fenoprofen	DML5VQ0	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Fenoprofen.	Rheumatoid arthritis [FA20]	[10]
Indomethacin	DMSC4A7	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Indomethacin.	Rheumatoid arthritis [FA20]	[10]
Tolmetin	DMWUIJE	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Tolmetin.	Rheumatoid arthritis [FA20]	[10]
Salicyclic acid	DM2F8XZ	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Salicyclic acid.	Seborrhoeic dermatitis [EA81]	[8]
Curcumin	DMQPH29	Minor	Increased risk of bleeding by the combination of Tenecteplase and Curcumin.	Solid tumour/cancer [2A00-2F9Z]	[25]
Warfarin	DMJYCVW	Major	Increased risk of bleeding by the combination of Tenecteplase and Warfarin.	Supraventricular tachyarrhythmia [BC81]	[12]
Caplacizumab	DMPUKA7	Major	Increased risk of bleeding by the combination of Tenecteplase and Caplacizumab.	Thrombocytopenia [3B64]	[19]
Apixaban	DM89JLN	Major	Increased risk of bleeding by the combination of Tenecteplase and Apixaban.	Thrombosis [DB61-GB90]	[6]
Cangrelor	DM8JRH0	Major	Increased risk of bleeding by the combination of Tenecteplase and Cangrelor.	Thrombosis [DB61-GB90]	[6]
Brilinta	DMBR01X	Moderate	Increased risk of bleeding by the combination of Tenecteplase and Brilinta.	Thrombosis [DB61-GB90]	[6]
Argatroban	DMFI46A	Major	Increased risk of bleeding by the combination of Tenecteplase and Argatroban.	Thrombosis [DB61-GB90]	[26]
Dicumarol	DMFQCB1	Major	Increased risk of bleeding by the combination of Tenecteplase and Dicumarol.	Thrombosis [DB61-GB90]	[12]
Cabozantinib	DMIYDT4	Major	Increased risk of bleeding by the combination of Tenecteplase and Cabozantinib.	Thyroid cancer [2D10]	[27]
Betrixaban	DM2C4RF	Major	Increased risk of bleeding by the combination of Tenecteplase and Betrixaban.	Venous thromboembolism [BD72]	[28]

References

• [1] Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Lancet. 1999 Aug 28;354(9180):716-22.
• [2] Fibrinolytic agents for the management of ST-segment elevation myocardial infarction. Pharmacotherapy. 2007 Nov;27(11):1558-70.
• [3] Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med. 2014 Apr 10;370(15):1402-11.
• [4] Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
• [5] Thrombolytic therapies: the current state of affairs. J Endovasc Ther. 2005 Apr;12(2):224-32.
• [6] Cerner Multum, Inc. "UK Summary of Product Characteristics.".
• [7] Product Information. Zontivity (vorapaxar). Merck & Company Inc, Whitehouse Station, NJ.
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• [15] Product Information. Panhematin (hemin). Recordati Rare Diseases Inc, Lebanon, NJ.
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• [18] Product Information. Aptivus (tipranavir). Boehringer-Ingelheim, Ridgefield, CT.
• [19] Cerner Multum, Inc. "Australian Product Information.".
• [20] Product Information. Bexxar I 131 Therapeutic (iodine I 131 tositumomab). GlaxoSmithKline, Research Triangle Park, NC.
• [21] Product Information. Calquence (acalabrutinib). Astra-Zeneca Pharmaceuticals, Wilmington, DE.
• [22] Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
• [23] Product Information. Iclusig (ponatinib). Ariad Pharmaceuticals Inc, Cambridge, MA.
• [24] Product Information. Sprycel (dasatinib). Bristol-Myers Squibb, Princeton, NJ.
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• [26] Product Information. Acova (argatroban) SmithKline Beecham, Philadelphia, PA.
• [27] Product Information. Cometriq (cabozantinib). Exelixis Inc, S San Francisco, CA.
• [28] Product Information. Bevyxxa (betrixaban). Portola Pharmaceuticals, South San Francisco, CA.