ATC Group: B01AD Enzymes

The World Health Organization's ATC classification organizes medical drugs based on therapeutic properties, chemical composition, and anatomy. It helps make essential medicines readily available globally and is widely used in the pharmaceutical industry.

Position of B01AD in the ATC hierarchy

Level Code Title
1 B Blood and blood forming organs
2 B01 Antithrombotic agents
3 B01A Antithrombotic agents
4 B01AD Enzymes

Group B01AD contents

Code Title
B01AD01 Streptokinase
B01AD02 Alteplase
B01AD03 Anistreplase
B01AD04 Urokinase
B01AD05 Fibrinolysin
B01AD06 Brinase
B01AD07 Reteplase
B01AD08 Saruplase
B01AD09 Ancrod
B01AD10 Drotrecogin alfa (activated)
B01AD11 Tenecteplase
B01AD12 Protein C

Active ingredients in B01AD

Active Ingredient Description

Alteplase is a recombinant human tissue-type plasminogen activator, a glycoprotein, which activates plasminogen directly to plasmin. Once bound to fibrin, it is activated, inducing the conversion of plasminogen to plasmin leading to the dissolution of the fibrin clot.


Anistreplase is a thrombolytic drug, also known as anisoylated plasminogen streptokinase activator complex (APSAC). Eminase is a lyophilized formulation of anistreplase, the p-anisoyl derivative of the primary Lys-plasminogen-streptokinase activator complex (a complex of Lys-plasminogen and streptokinase). It is used in the emergency treatment of myocardial infarction and pulmonary emboli.

Drotrecogin alfa

Drotrecogin alfa is a recombinant version of the natural plasma-derived activated Protein C, from which it differs only by unique oligosaccharides in the carbohydrate portion of the molecule. Activated Protein C is a crucial coagulation regulator. Furthermore, Activated Protein C is an important modulator of the systemic response to infection and has antithrombotic and profibrinolytic properties. Drotrecogin alfa has similar properties to those of endogenous human Activated Protein C.

Protein C

Protein C is a serine protease with potent anticoagulant effects, especially in the presence of its cofactor protein S. Protein C exerts its effect by the inactivation of the activated forms of factors V and VIII which leads to a decrease in thrombin formation. Protein C has also been shown to have profibrinolytic effects.


Reteplase is a recombinant plasminogen activator that catalyzes the cleavage of endogenous plasminogen to generate plasmin. This plasminogenolysis occurs preferentially in the presence of fibrin. Plasmin in turn degrades fibrin, which is the main component of the matrix of thrombi, thereby exerting its thrombolytic action.


Biofactor streptokinase is a highly purified streptokinase derived from β haemolytic streptococci of Lancefield group C. The activation of the endogenous fibrinolytic system is initiated by the formation of a streptokinase-plasminogen complex. This complex possesses activator properties and converts plasminogen into the proteolytic and fibrinolytic active plasmin.


Tenecteplase is a recombinant fibrin-specific plasminogen activator that is derived from native t-PA by modifications at three sites of the protein structure. It binds to the fibrin component of the thrombus (blood clot) and selectively converts thrombus-bound plasminogen to plasmin, which degrades the fibrin matrix of the thrombus. Tenecteplase has a higher fibrin specificity and greater resistance to inactivation by its endogenous inhibitor (PAI-1) compared to native t-PA.


Urokinase is a highly purified form of naturally occurring human urokinase extracted from urine. It is a thrombolytic agent which converts plasminogen into plasmin (fibrinolysin) a proteolytic enzyme that breaks down fibrin as well a fibrinogen and other plasma proteins.

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