Aminocaproic Acid

Aminocaproic Acid is a prescription medication used for the treatment of fibrinolytic bleeding.

• Aminocaproic Acid is available under the following different brand names: Amicar

Adult dosage

Injectable solution

• 250mg/mL

Syrup

• 1.25g/5mL

Tablet

• 500mg
• 1,000mg

Fibrinolytic Bleeding

Adult dosage

• Initial: 4-5 g IV/orally during 1st hr, THEN 1-1.25 g orally  every hour, OR
• Continuous IV infusion at 1 g/hr
• Continue for 8 hours or until bleeding is controlled, not to exceed 30 g/day

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Aminocaproic Acid include:

• muscle weakness,
• headache,
• nausea,
• vomiting,
• stomach pain,
• diarrhea,
• stuffy nose,
• watery eyes,
• vision problems,
• ringing in the ears,
• itching,
• rash, and
• decreased amount of semen while having an orgasm (in men).

Serious side effects of Aminocaproic Acid include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• unexplained muscle pain,
• weakness,
• fever,
• unusual tiredness,
• dark-colored urine,
• ill feeling,
• chills,
• sore throat,
• mouth sores,
• easy bruising,
• unusual bleeding,
• numbness,
• tingling,
• cold feeling in the arms or legs,
• slow heart rate,
• shallow breathing,
• lightheadedness,
• little or no urination,
• painful or difficult urination,
• swelling in the feet or ankles,
• feeling tired,
• sudden numbness or weakness,
• tingling or cold feeling in arm or leg,
• sudden cough,
• chest pain, and
• swelling, warmth, or redness in your arms or legs

Rare side effects of Aminocaproic Acid include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Aminocaproic acid has severe interactions with no other drugs.
• Aminocaproic acid has serious interactions with no other drugs.
• Aminocaproic acid has moderate interactions with the following drugs:
  • defibrotide
  • ethinylestradiol
  • mestranol
• Aminocaproic acid has minor interactions with no other drugs. 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• In presence of DIC without concomitant heparin
• Evidence of active intravascular clotting process

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Aminocaproic acid?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Aminocaproic acid?”

Cautions

• Use caution in renal/cardiac/hepatic impairment
• Risk of myopathy
• In patients with upper urinary tract bleeding, therapy has been known to cause intrarenal obstruction in form of glomerular capillary thrombosis or clots in the renal pelvis and ureters; for this reason, the drug should not be used in hematuria of upper urinary tract origin, unless possible benefits outweigh risks
• Avoid rapid IV administration
  • Therapy inhibits both actions of plasminogen activators and to a lesser degree, plasmin activity; the drug should not be administered without a definite diagnosis and/or laboratory finding indicative of hyperfibrinolysis (hyperplasminemia)
  • Preservative benzyl alcohol linked to fatal "Gasping Syndrome" in premature neonates
  • Skeletal muscle weakness with necrosis of muscle fibers reported following prolonged administration (rare); Clinical presentation may range from mild myalgias with weakness and fatigue to severe proximal myopathy with rhabdomyolysis, myoglobinuria, and acute renal failure; muscle enzymes, especially creatine phosphokinase (CPK) are elevated; monitor CPK levels in patients on long-term therapy; stop therapy if the rise in CPK noted; resolution follows discontinuation of therapy; however, the syndrome may recur if therapy restarted
  • Inhibition of fibrinolysis may theoretically result in clotting or thrombosis; there is no definite evidence that therapy has been responsible for few reported cases of intravascular clotting which followed treatment; rather, it appears that intravascular clotting was most likely due to patient's preexisting clinical condition, eg, the presence of DIC; it has been postulated that extravascular clots formed in vivo may not undergo spontaneous Iysis as do normal clots
  • Therapy should not be administered with Factor IX Complex concentrates or Anti-Inhibitor Coagulant concentrates, as the risk of thrombosis may increase
  • Reports have appeared in the literature of increased incidence of certain neurological deficits,j including hydrocephalus, cerebral ischemia, or cerebral vasospasm associated with the use of antifibrinolytic agents in the treatment of subarachnoid hemorrhage (SAH); all of these events have also been described as part of the natural course of SAH, or as a consequence of diagnostic procedures such as angiography; drug relatedness remains unclear
• Differentiate primary fibrinolysis from disseminated intravascular coagulation (DIC)
• When there is uncertainty as to whether the cause of bleeding is primary fibrinolysis or disseminated intravascular coagulation (DIC), a distinction must be made before administering therapy
• 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 presence of primary fibrinolysis
  • The euglobulin clot Iysis test is abnormal in primary fibrinolysis but normal in DIC

Pregnancy and Lactation

• Use with caution if benefits outweigh risks during pregnancy
• Lactation
  • Not known whether excreted in breast milk, use caution.