Aminocaproic acid


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Treatment and prophylaxis of haemorrhage due to hyperfibrinolysis Initial: 4-5 g, followed by 1-1.25 g hrly for up to 8 hr. Max: 24 g/day. Patients w/ haemophilia undergoing dental extraction 50-100 mg/kg 4-6 hrly started before the procedure up to 7-10 days. Max: 24 g/day. IV Treatment and prophylaxis of haemorrhage due to hyperfibrinolysis As 2% soln: Initial: 4-5 g over 1 hr, followed by continuous infusion of 1 g/hr for up to 8 hr. Max: 24 g/day.
Dosage Details
Intravenous
Treatment and prophylaxis of haemorrhage
Adult: For bleeding due to hyperfibrinolysis: As 2% soln: Initially, 4-5 g over 1 hr, followed by continuous infusion at a rate of 1 g/hr for up to 8 hr or until bleeding has been controlled. Max: 24 g daily.

Oral
Treatment and prophylaxis of haemorrhage
Adult: For bleeding due to hyperfibrinolysis: Initially, 4-5 g, followed by 1-1.25 g hrly for up to 8 hr or until bleeding has been controlled. Max: 24 g daily.

Oral
Patients with haemophilia undergoing dental extraction
Adult: 50-100 mg/kg (up to 6 g) 4-6 hrly, started before the procedure up to a total of 7-10 days. Max: 24 hr daily.
Renal Impairment
Reduce dose if necessary.
Administration
May be taken with or without food. May be taken w/ meals to prevent GI upset.
Reconstitution
Dilute w/ NaCl 0.9%, dextrose 5%, or Ringer’s inj.
Contraindications
Active intravascular clotting process, disseminated intravascular coagulation (w/o heparin). Concomitant use w/ factor IX complex and anti-inhibitor coagulant complex.
Special Precautions
Patient w/ cardiac disease, haematuria of upper urinary tract, uraemia. Admin by rapid IV inj of undiluted soln. Hepatic and renal impairment. Pregnancy and lactation.
Adverse Reactions
Headache, oedema, tinnitus, nasal and conjunctival congestion, malaise; anaphylaxis, rash; thrombosis; hypotension, bradycardia, peripheral ischaemia; abdominal pain, diarrhoea, nausea, vomiting, agranulocytosis, coagulation disorder, leucopenia, thrombocytopenia; increased CPK, muscle weakness, myalgia, myopathy, myositis, rhabdomyolysis; increase BUN, confusion, convulsions, delirium, dizziness, hallucinations, intracranial HTN, stroke, syncope, dyspnoea, pulmonary embolism, pruritus; decreased vision, watery eyes, cardiac and hepatic damage, renal failure.
IV/Parenteral/PO: C
MonitoringParameters
Monitor creatine phosphokinase (CPK) for signs of muscle damage esp in patients receiving long-term therapy. Monitor for fibrinogen, fibrin split products, BUN, and creatinine.
Overdosage
Symptoms: Transient hypotension, severe acute renal failure, seizures. Management: Haemodialysis or peritoneal dialysis may be beneficial.
Drug Interactions
Enhanced thrombogenic effect w/ oral tretinoin. May increase risk of thrombosis w/ fibrinogen concentrate.
Potentially Fatal: May enhance risk of thrombosis w/ factor IX complex and anti-inhibitor coagulant complex.
Lab Interference
May cause prolongation of template bleeding time at dosages >24 g daily.
Action
Description: Aminocaproic acid is an antifibrinolytic used similarly to tranexamic acid. It inhibits fibrinolysis by competitively binding to plasminogen, blocking its binding to fibrin and the subsequent conversion to plasmin.
Onset: Approx 1-72 hr.
Pharmacokinetics:
Absorption: Rapidly and completely absorbed from the GI tract. Bioavailability: 100% (oral). Time to peak plasma concentration: W/in 2 hr (oral).
Distribution: Widely distributed through intravascular and extravascular compartments. Volume of distribution: 23 L (oral); 30 L (IV).
Metabolism: Metabolised minimally in the liver.
Excretion: Via urine (65% as unchanged drug, approx 11% as metabolites). Elimination half-life: 1-2 hr.
Chemical Structure

Chemical Structure Image
Aminocaproic acid

Source: National Center for Biotechnology Information. PubChem Database. Aminocaproic acid, CID=564, https://pubchem.ncbi.nlm.nih.gov/compound/Aminocaproic-acid (accessed on Jan. 20, 2020)

Storage
Store between 15-30°C. Do not freeze.
MIMS Class
ATC Classification
B02AA01 - aminocaproic acid ; Belongs to the class of amino acid antifibrinolytics. Used in the treatment of hemorrhage.
References
Aminocaproic Acid Injection, Solution (American Regent, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/09/2016.

Aminocaproic Acid Solution and Tablet (Clover Pharmaceuticals Corp.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 08/09/2016.

Anon. Aminocaproic Acid. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 08/09/2016.

Buckingham R (ed). Aminocaproic Acid. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/09/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Aminocaproic Acid. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 08/09/2016.

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