There isn't a definite and universally accepted list of contraindications, and it seems to be a tendency to become simpler over the years. Beware that references differ in some issues.

⚠ Absolute contraindications (4, 7, 8, 10)

• Previous intracranial hemorrhage or stroke of unknown origin at any time

• Ischemic stroke in the preceding 6 months

• Central nervous system damage or neoplasms or arteriovenous malformation

• Recent major trauma / surgery / head injury (within the preceding month)

• Gastrointestinal bleeding within the past month

• Known bleeding disorder (excluding menses)

• Aortic dissection

• Non-compressible punctures in the past 24 hours (e.g. liver biopsy, lumbar puncture)

• Active internal bleeding

⚠ Relative contraindications (4, 7, 8, 10)

• Transient ischemic attack in the preceding 6 months

• Oral anticoagulant therapy

• Pregnancy or within 1 week postpartum

• Refractory hypertension (SBP >180mmHg and/or DBP >110 mmHg)

• Advanced liver disease

• Infective endocarditis

• Active peptic ulcer

• Prolonged or traumatic resuscitation

• Alteplase

• Tenecteplase

1. GUSTO investigators. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med. 1993;329(10):673-682. doi:10.1056/NEJM199309023291001
   Pubmed

2. NINDS - National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333(24):1581-1587. doi:10.1056/NEJM199512143332401
   Pubmed

3. ASSENT 2 - Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT-2) Investigators, Van De Werf F, Adgey J, et al. Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Lancet. 1999;354(9180):716-722. doi:10.1016/s0140-6736(99)07403-6
   Pubmed

4. ECASS III - Hacke W, Kaste M, Bluhmki E, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008;359(13):1317-1329. doi:10.1056/NEJMoa0804656
   Pubmed

5. NOR-TEST - Logallo N, Kvistad CE, Nacu A, et al. The Norwegian tenecteplase stroke trial (NOR-TEST): randomised controlled trial of tenecteplase vs. alteplase in acute ischaemic stroke. BMC Neurol. 2014;14:106. Published 2014 May 15. doi:10.1186/1471-2377-14-106
   Pubmed

6. EXTEND-IA-TNK - Campbell BC, Mitchell PJ, Churilov L, et al. Tenecteplase versus alteplase before endovascular thrombectomy (EXTEND-IA TNK): A multicenter, randomized, controlled study. Int J Stroke. 2018;13(3):328-334. doi:10.1177/1747493017733935
   Pubmed

7. Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2018 Mar;49(3):e138] [published correction appears in Stroke. 2018 Apr 18;:]. Stroke. 2018;49(3):e46-e110. doi:10.1161/STR.0000000000000158
   Pubmed

8. Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-177. doi:10.1093/eurheartj/ehx393
   Pubmed

9. EXTEND-IA-TNK Part 2 - Campbell BC, Mitchell PJ, Churilov L, et al. Determining the optimal dose of tenecteplase before endovascular therapy for ischemic stroke (EXTEND-IA TNK Part 2): A multicenter, randomized, controlled study. Int J Stroke. 2020;15(5):567-572. doi:10.1177/1747493019879652
   Pubmed

10. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. doi:10.1093/eurheartj/ehz405
    Pubmed

11. NOR-TEST 2, Part A - Kvistad CE, Næss H, Helleberg BH, et al. Tenecteplase versus alteplase for the management of acute ischaemic stroke in Norway (NOR-TEST 2, part A): a phase 3, randomised, open-label, blinded endpoint, non-inferiority trial. Lancet Neurol. 2022;21(6):511-519. doi:10.1016/S1474-4422(22)00124-7
    Pubmed