CAS_number = 9001-90-5
ATC_suffix = AD05
molecular_weight = ~ 13,800 g/mol
bioavailability = virtually none
metabolism = local inactivation
elimination_half-life = almost completely inactivated after 24 hours
pregnancy_category = C
legal_status = Rx only (where available)
routes_of_administration = ointment for local application, in combination with desoxyribonuclease
Fibrinolysin is an enzyme derived from plasma of
bovineorigin or extracted from cultures of certain bacteria. It is used locally only and exclusively together with the enzyme desoxyribonuclease (extracted from bovine pancreas). Fibrinolysin and desoxyribonuclease both act as lytic enzymes. The combination is available as ointment containing 1 BU (Biological Unit) fibrinolysin and 666 BUs desoxyribonuclease per gram.
Fibrinolysin attacks and inactivates
fibrinmolecules occurring in undesirable exudates on the surface of the human body and on human mucosa, e.g., in superficial woundsand burns, while desoxyribonuclease targets and destroys (human) DNA. The combination of the two enzymes has a synergistic effect on necrotic but not on living tissue. According to the manufacturer the ointment provides enhanced wound cleaning and accelerates the healing process.
Both enzymes are marginally resorbed into systemic circulation because of their very high molecular weight and their macromolecular structure.
The activity of both enzymes is almost completely exhausted after 24 hours. Usually, it is necessary to repeat the application (and renew the dressing) every 6 to 8 hours until healing becomes complete.
The ointment is marketed by
Pfizerunder the brand name Fibrolan in a variety of countries (e.g. Switzerland). It is currently not approved in the USA.
Where approved, Fibrolan has been licensed on the basis of claimed good therapeutical experience, but adequate and well controlled studies are still lacking.
In the past, combinations with the antibiotic
chloramphenicolwere available, but because chloramphenicol in any form of application has led to aplastic anemiaand death, these were banned. Additionally, combinations with the antifibrinolytic agent tranexamic acidhave been withdrawn from pharma markets.
Enzymatic wound cleaning to assist healing of minor burns, superficial wounds,
ulcus cruris, and superficial hematoma.
Contraindications and Precautions
The ointment should not be used in patients with a known
hypersensitivityto any ingredient. It should be used with caution in patients with hypersensitivity to bovine proteins in general and in pregnant women (category C), because no human data is available.
Infrequently, local reactions such as increased pain or a stitching/burning sensation are noticed. No systemic
anticoagulantactivity has been seen due to the exclusively local character of treatment.
* Swiss scientific product information
* http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6226244&dopt=Abstract (on chemical/biochemical properties)
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