N Engl J Med 380: 1326 - 1335, 2019. doi: 10.1056/NEJMoa1814051 Thrombolytic (Fibrinolytic) Drugs Thrombolytic drugs, which include alteplase, tenecteplase, and streptokinase, lyse clots and may be more effective than heparin alone in selected patients, but the risk of bleeding is higher than with heparin alone.