Fibrinolytic therapy is used in the treatment of ST segment elevation myocardial infarction (STEMI), acute stroke and other less common indications such as pulmonary embolism and acute deep venous thrombosis. The most commonly used agents are tPA (tissue plasminogen activator), alteplase, reteplase, streptokinase, tenecteplase, urokinase.

Streptokinase is immunogenic (isolated from streptococci bacteria) and once exposed, a repeat exposure can cause severe allergic reactions including anaphylaxis and thus is not recommended.

Tenecteplase is administered as a single bolus due to its long half-life which is convenient.

Urokinase was initially isolated from human urine, is expensive and not commonly used. It is not immunogenic like streptokinase.

The other fibrinolytic (thrombolytic) agents require a bolus followed by an infusion.