Dosing and uses of Amicar (aminocaproic acid)
Adult dosage forms and strengths
injectable solution
- 250mg/mL
syrup
- 1.25g/5mL
tablet
- 500mg
Fibrinolytic Bleeding
Initial: 4-5 g IV/PO during 1st hr, THEN 1-1.25 g PO q1hr, Or
Continuous IV infusion at 1 g/hr
Continue for 8 hr or until bleeding controlled, not to exceed 30 g/day
Decrease dose in cardiac, renal, or hepatic disease
Hyphema (Orphan)
Topical gel (Caprogel) for treatment of traumatic hyphema of the eye
Administration: TopicaL
Orphan indication sponsor
- Eastern Virginia Medical School Department of Ophthalmology; 880 Kempsville Road, Suite 2500; Norfolk, VA 23502-3990
Other Indications & Uses
Bleeding due to systemic hyperfibrinolysis
Off-label: prevent recurrence of subarachnoid hemorrhage; prevent hereditary angioneurotic edema attacks; reduce post-op bleeding
Pediatric dosage forms and strengths
injectable solution
- 250mg/mL
syrup
- 1.25g/5mL
tablet
- 500mg
Load: 100-200 mg/kg IV/PO x1
Maintenance: 400 mg/kg/day divided q6hr IV/PO
Amicar (aminocaproic acid) adverse (side) effects
Frequency not defined
Confusion
Vision decrease
Vomiting
Headache
Convulsions
Malaise
Muscle weakness
Dizziness
Tinnitus
Nausea
Bradycardia
Thrombosis
Edema
Hypotension
Stroke
Syncope
Intracranial hypertension
Peripheral ischemia
Pulmonary embolism
Dyspnea
Congestion
Diarrhea
Abdominal pain
Leukopenia
Agranulocytosis
Coagulation disorder
Dry ejaculation
Injection site reactions (pain/necrosis)
Myopathy
Pruritus
Rash
Renal failure
Anaphylaxis
Warnings
Contraindications
DIC
Hematuria of upper urinary tract origin
Cautions
Renal/cardiac/hepatic impairment
Risk of myopathy
Avoid rapid IV administration
Preservative benzyl alcohol linked to fatal "Gasping Syndrome" in premature neonates
Pregnancy and lactation
Pregnancy category: C
Lactation: not known whether excreted in breast milk, use caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Amicar (aminocaproic acid)
Onset: 1 hr
Duration: 3-4 hr (after 1 dose)
Half-Life, Terminal: 2 hr
Vd: 23 L (PO), 30 L (IV)
Metabolites: adipic acid
Clearance: 169 mL/min
Excretion: urine (65%)
Dialyzable: HD: yes
Mechanism of action
Inhibits fibrinolysis through inhibition of plasminogen activator substances
Exhibits antiplasmin activity
Administration
IV Compatibilities
Solution: D5W, NS, Ringer's
Additive: netilmicin
Y-site: fenoldopam
IV Administration
Initial 5 g in 250 mL over 1 hr, each subsequent gram in 50-100 mL at 1 g/hr
Rapid injection undiluted into a vein is not recommended
Continue for about 8 hr or until bleeding has been controlled
Storage
Store between 15-30°C (59-86°F)
Do not freeze
