Aminocaproic Acid

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Generic Name of Aminocaproic Acid - Learn More

Aminocaproic Acid

Aminocaproic Acid Precaution - What You Need to Know

Aminocaproic acid is a synthetic antifibrinolytic agent used to prevent or control excessive bleeding by inhibiting fibrinolysis. While it is generally safe when used appropriately, it should be used with caution in patients with a history of thromboembolic events or a predisposition to clot formation, such as those with a history of deep vein thrombosis (DVT), pulmonary embolism (PE), or stroke. The use of aminocaproic acid in these patients can potentially increase the risk of clot formation due to the drug’s ability to inhibit fibrinolysis, which is essential in breaking down unwanted blood clots. Therefore, the benefits of aminocaproic acid in preventing bleeding should be carefully weighed against the risk of inducing thrombotic complications.

Patients with renal impairment should also be monitored closely when receiving aminocaproic acid, as the drug is primarily excreted via the kidneys. Dose adjustments may be necessary in individuals with impaired kidney function to avoid accumulation and toxicity. Additionally, caution should be taken in patients with active bleeding from disseminated intravascular coagulation (DIC), as inhibiting fibrinolysis in such conditions could worsen the clotting problem.

During pregnancy, aminocaproic acid is classified as a Category C drug, meaning it should be used only if the potential benefits justify the potential risks to the fetus. It should be used with caution in breastfeeding mothers, as there is limited data on its excretion in breast milk, although no major risks have been reported.

Aminocaproic Acid Indication - Uses and Benefits

Aminocaproic acid is primarily indicated for the treatment of bleeding disorders resulting from excessive fibrinolysis. This includes conditions such as postoperative bleeding (especially after surgery involving the prostate or heart), bleeding associated with fibrinolytic therapy (e.g., thrombolytic agents), or bleeding associated with conditions like hemophilia or severe liver disease where clot formation is impaired. It is also used to manage bleeding due to urothelial surgery, such as bladder or kidney surgeries, as well as to prevent hemorrhage following certain types of dental procedures in hemophiliacs.

Aminocaproic acid is also used in cases of acute bleeding associated with trauma or surgical interventions where fibrinolysis might be excessive, leading to continuous clot dissolution. Additionally, it may be used off-label to control excessive bleeding during other specific surgeries, like dental or tonsillectomy procedures, particularly in patients with coagulopathy or risk of excessive bleeding.

Although its use is relatively focused on managing bleeding due to excessive fibrinolysis, the drug is sometimes used off-label in treating certain conditions where bleeding is secondary to an underlying clotting disorder, though these uses are less commonly studied.

Aminocaproic Acid Contraindications - Important Warnings

Aminocaproic acid is contraindicated in patients with a known hypersensitivity or allergy to the drug or any of its components. It is also contraindicated in individuals with active intravascular clotting (disseminated intravascular coagulation, DIC) without concomitant heparin therapy, as its antifibrinolytic action could exacerbate clotting and lead to widespread thrombosis. In such cases, the inhibition of fibrinolysis can worsen clot formation, contributing to organ failure or even death.

Aminocaproic acid is not recommended for patients with a history of thromboembolic disorders, such as deep vein thrombosis (DVT), pulmonary embolism (PE), or cerebrovascular accidents (strokes), due to the increased risk of thrombus formation. In addition, it should be avoided in patients with significant renal impairment (e.g., end-stage renal disease) unless closely monitored, as the drug is excreted through the kidneys, and renal dysfunction may lead to drug accumulation and toxicity.

In pregnant or breastfeeding women, aminocaproic acid should be used only if clearly needed, as there is insufficient data on its safety in these populations. The drug should be avoided in the first trimester unless absolutely necessary.

Aminocaproic Acid Side Effects - What to Expect

Common side effects of aminocaproic acid are generally mild and include gastrointestinal disturbances such as nausea, vomiting, or diarrhea. These symptoms are typically dose-dependent and can be managed by adjusting the infusion rate or reducing the dose.

More severe side effects, although rare, may include thromboembolic events, such as deep vein thrombosis (DVT), pulmonary embolism (PE), or stroke. This is especially concerning in patients with pre-existing thrombotic risk factors, as aminocaproic acid can increase the risk of clot formation by inhibiting fibrinolysis. Signs of these complications should be promptly addressed, and aminocaproic acid should be discontinued immediately if any thrombotic event is suspected.

Other potential side effects include renal toxicity, particularly in patients with pre-existing kidney problems or those receiving high doses for prolonged periods. This may manifest as decreased urine output, edema, or electrolyte disturbances such as hyperkalemia. In very rare cases, allergic reactions (e.g., rash, itching, or anaphylaxis) have been reported.

Aminocaproic Acid Pregnancy Category ID - Safety Information

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Aminocaproic Acid Mode of Action - How It Works

Aminocaproic acid exerts its effects by inhibiting the activation of plasminogen to plasmin, a key enzyme responsible for breaking down fibrin in blood clots. It works as an antifibrinolytic agent by binding to lysine-binding sites on plasminogen, preventing it from attaching to fibrin and ultimately reducing the dissolution of blood clots.

At a molecular level, aminocaproic acid competes with plasminogen for binding to fibrin, thereby decreasing the proteolytic breakdown of fibrin by plasmin. This action stabilizes the clot and is beneficial in conditions where excessive fibrinolysis (the breakdown of blood clots) is present, such as in postoperative bleeding, trauma, or during fibrinolytic therapy.

By inhibiting fibrinolysis, aminocaproic acid allows for more efficient clot formation and reduces the risk of uncontrolled bleeding. However, this inhibition of clot breakdown must be carefully managed, as excessive clot formation can lead to thrombotic complications. The drug primarily works within the blood plasma, and its effects are most evident when there is a significant clotting disturbance due to an overactive fibrinolytic system.

Aminocaproic Acid Drug Interactions - What to Avoid

Aminocaproic acid may interact with anticoagulant medications, particularly oral anticoagulants like warfarin, and thrombolytic agents. The concomitant use of aminocaproic acid with these drugs may reduce their effectiveness by inhibiting fibrinolysis, leading to an increased risk of thrombosis and embolic events. If aminocaproic acid is prescribed alongside anticoagulants, careful monitoring of coagulation parameters (e.g., INR, activated partial thromboplastin time, or APTT) is recommended.

The drug may also interact with oral contraceptives, increasing the risk of clotting, as the combination of a synthetic antifibrinolytic and the pro-coagulant effect of oral contraceptives can increase the risk of thromboembolic complications. Similarly, it may alter the pharmacokinetics of certain drugs metabolized by the liver.

In patients receiving aminocaproic acid in combination with other antifibrinolytic drugs, such as tranexamic acid, the potential for excessive fibrinolysis inhibition and subsequent clot formation may be elevated. Therefore, combining these agents should be done with caution and close monitoring.

Aminocaproic Acid Adult Dose - Recommended Dosage

The recommended adult dose of aminocaproic acid depends on the condition being treated. For general bleeding control due to fibrinolysis, an initial intravenous dose of 4–5 grams is typically administered over 20–30 minutes, followed by a continuous infusion of 1–2 grams per hour. The duration of therapy depends on the patient’s response and clinical condition but is usually continued until bleeding has been controlled. In cases of surgery or trauma, the dose can be adjusted based on the severity of bleeding and the patient’s clinical status.

For prevention of bleeding during high-risk surgeries or procedures, a dose of 1–2 grams may be given prior to the procedure, with additional doses given during and after the procedure depending on the ongoing risk of bleeding.

The drug should be administered intravenously, and care should be taken to adjust the dose based on renal function and the severity of bleeding. Close monitoring of coagulation parameters is required to prevent adverse effects, particularly in patients with a history of thromboembolic disease.

Aminocaproic Acid Child Dose - Dosage for Children

For pediatric patients, the dosage of aminocaproic acid depends on the child’s weight, age, and the condition being treated. In general, the starting dose for children is typically 50–100 mg/kg of body weight, which may be administered intravenously. For ongoing therapy, a continuous infusion of 10–20 mg/kg/hour can be used to maintain hemostasis in cases of excessive bleeding due to fibrinolysis.

In neonates and infants, lower doses may be necessary, and the use of aminocaproic acid should be carefully considered due to the limited data on its safety in very young patients. Monitoring of renal and hepatic function is essential, particularly in infants, as their metabolic processes may differ from those of older children or adults.

D

osing in children should always be adjusted based on clinical response and monitored carefully for any signs of bleeding or thrombotic complications.

Aminocaproic Acid Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, aminocaproic acid should be used with caution, as the drug is primarily excreted through the kidneys. In cases of mild to moderate renal dysfunction, dose adjustments may not be necessary, but the patient should be carefully monitored for signs of drug accumulation, such as renal toxicity or electrolyte imbalances.

For patients with severe renal impairment, dose reductions may be necessary to avoid excessive accumulation of aminocaproic acid. In these patients, the recommended dose should be reduced by half or more, and the infusion rate should be adjusted based on renal function. Close monitoring of renal function (e.g., serum creatinine and urine output) is crucial.

Dialysis may be required for patients with end-stage renal disease, and the dose may need to be adjusted after dialysis sessions to avoid excessive accumulation.