Aminocaproic acid

Indications

Aminocaproic acid used to treat excessive postoperative bleeding, especially after procedures in which a great amount of bleeding is expected, such as cardiac surgery. It can be given orally or intravenously. A meta-analysis found that lysine analogs like Aminocaproic acid significantly reduced blood loss in patients undergoing coronary artery bypass grafting. Aminocaproic acid can also be used to treat the overdose and/or toxic effects of the thrombolytic pharmacologic agents tissue plasminogen activator and streptokinase.

Pharmacology

The fibrinolysis-inhibitory effects of Aminocaproic acid appear to be exerted principally via inhibition of plasminogen activators and to a lesser degree through antiplasmin activity.

Dosage & Administration

Dosage of  Aminocaproic acid must be adjusted to individual cases according to the severity of the hemmohagic event. It must however born in mind that Aminocaproic acid cleared rapidly by renal rough, so that administration must be repeated every 4-6 hours. The average dose is 8-16 gm a day.i.e. 1 ampule of Aminocaproic acid according to the case, every 6 hours.

Aminocaproic acid is equally effective by mouth and intarvenous injection. In cases of particular severity, or when it is sought to obtain a high blood concentration quickly it is advisable to start treatment by intravenous rough, with slow injection of two Aminocaproic acid ampules with an interval of 30-60 minutes between them, continuing with divided doses until a dosage of 20-25 grams in the 24 hour is reached.

In any case, administration of the drug must be continued until complete cessation of all symptoms. Aminocaproic acid could be intravenously administered, following suitable dilution in Physiological solution.
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Contraindications

  • Aminocaproic acid should not be used when there is evidence of an active intravascular clotting process.
  • When there is uncertainty as to whether the cause of bleeding is primary fibrinolysis or disseminated intravascular coagulation (DIC), this distinction must be made before administering Aminocaproic acid Injection.
  • The following tests can be applied to differentiate the two conditions:
  • Platelet count is usually decreased in DIC but normal in primary fibrinolysis.
  • Protamine paracoagulation test is positive in DIC; a precipitate forms when protamine sulfate is dropped into citrated plasma. The test is negative in the presence of primary fibrinolysis.
  • The euglobulin clot lyses test is abnormal in primary fibrinolysis but normal in DIC.
  • Aminocaproic acid Injection must not be used in the presence of DIC without concomitant heparin.

Side Effects

Mild muscle pain or weakness; headache, tired feeling; nausea, vomiting, stomach pain, diarrhea; (in men) decreased amount of semen when having an orgasm; stuffy nose, watery eyes; vision problems, ringing in your ears; or Mild skin rash.

Pregnancy & Lactation

Pregnancy Category C. Animal reproduction studies have not been conducted with aminocaproic acid. It is also not known whether aminocaproic acid can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Aminocaproic Acid Injection should be given to a pregnant woman only if clearly needed.

Precautions & Warnings

Safety and efficacy have not been established in patients younger than 18 years.

Therapeutic Class

Anti-fibrinolytic drugs, Haemostatic drugs

Storage Conditions

Store in a cool, dry place, protected from light. Store the suspension below 30° C. Keep out of reach of children.