Aminocaproic acid is indicated for the management of excessive postoperative bleeding, particularly following procedures with a high risk of bleeding such as cardiac surgery. It may be administered orally or intravenously. Evidence from meta-analyses suggests that lysine analogues like aminocaproic acid can significantly reduce blood loss in patients undergoing coronary artery bypass grafting. Additionally, aminocaproic acid is used in the treatment of overdose and/or toxic effects of thrombolytic agents such as tissue plasminogen activator and streptokinase.

Aminocaproic acid helps control bleeding by preventing the breakdown of blood clots (fibrinolysis). It works mainly by blocking plasminogen activators—the substances that trigger clot breakdown. To a lesser extent, it also has weak antiplasmin activity, which further helps stabilize clots.

Dosage of Aminocaproic acid should be individualized based on the severity of bleeding. Since the drug is rapidly cleared by the kidneys, administration should be repeated every 4–6 hours. The usual daily dose ranges from 8–16 g. Typically, 1 ampoule may be administered every 6 hours depending on the clinical condition.

Aminocaproic acid is effective when given orally or intravenously. In severe cases, or when a rapid high plasma concentration is required, treatment should be initiated intravenously. This may involve slow IV injection of two ampoules at intervals of 30–60 minutes, followed by divided doses until a total of 20–25 g is administered within 24 hours.

Treatment should be continued until complete cessation of bleeding. Aminocaproic acid can be administered intravenously after proper dilution in physiological (normal saline) solution.

• Aminocaproic acid should not be used in patients with evidence of active intravascular clotting
• If there is uncertainty whether bleeding is due to primary fibrinolysis or disseminated intravascular coagulation (DIC), this distinction must be made before starting Aminocaproic acid
• The following tests may help differentiate these conditions:
• Platelet count is typically reduced in DIC but remains normal in primary fibrinolysis
• Protamine paracoagulation test is positive in DIC (precipitate forms when protamine sulfate is added to citrated plasma) but negative in primary fibrinolysis
• Euglobulin clot lysis test is abnormal in primary fibrinolysis but normal in DIC
• Aminocaproic acid should not be used in DIC unless heparin is given concurrently

Mild muscle pain or weakness, headache, fatigue, nausea, vomiting, abdominal discomfort, and diarrhea may occur. In men, a reduced amount of semen during orgasm has been reported. Other effects include nasal congestion, watery eyes, visual disturbances, ringing in the ears (tinnitus), and mild skin rash.

Pregnancy Category C. Animal reproduction studies with aminocaproic acid have not been conducted. It is also unknown whether aminocaproic acid can cause fetal harm or affect reproductive capacity when administered to a pregnant woman. Aminocaproic acid should be used during pregnancy only if clearly necessary.

The safety and effectiveness of aminocaproic acid have not been established in patients below 18 years of age.

Anti-fibrinolytic drugs, Haemostatic agents

Store in a cool and dry place, protected from light. Keep the suspension below 30°C. Keep out of the reach of children.