Aminocaproic Acid

DEA Class; Rx

Common Brand Names; Amicar

In presence of DIC without concomitant heparin

Evidence of active intravascular clotting process

Use cautioni 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 renal pelvis and ureters; for this reason, drug should not be used in hematuria of upper urinary tract origin, unless possible benefits outweigh risks

Avoid rapid IV administration

Therapy inhibits both action of plasminogen activators and to a lesser degree, plasmin activity; 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 rise in CPK noted; resolution follows discontinuation of therapy; however, 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 risk of thrombosis may increase

Reports have appeared in literature of increased incidence of certain neurological deficits,j including hydrocephalus, cerebral ischemia, or cerebral vasospasm associated with use of antifibrinolytic agents in 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

Pregnancy Category: C

Lactation: Not known whether excreted in breast milk, use caution