Dosing & Uses
Dosage Forms & Strengths
Initial: 4-5 g IV/PO during 1st hr, THEN 1-1.25 g PO q1hr, OR
Continue for 8 hr or until bleeding controlled, not to exceed 30 g/day
Decrease dose in cardiac, renal, or hepatic disease
Control of Bleeding with Severe Thrombocytopenia (Off-label)
Initial: 100 mg/kg IV over 30-60 min; not to exceed 5 g
Maintenance: 1-4 g PO/IV q4-8hr for 1 g/hr; not to exceed 24 g/24hr
Topical gel (Caprogel) for treatment of traumatic hyphema of the eye
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
Dosage Forms & Strengths
Prevention of Perioperative Bleeding Associated with Cardiac Surgery (Off-label)
100 mg/kg IV over 20-30 min after induction prior to incision
100 mg/kg IV over 20-30 min during cardiopulmonary bypass
100 mg/kg IV after heparin reversal
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Injection site reactions (pain/necrosis)
Evidence of active intravascular clotting process
Use cautioni in renal/cardiac/hepatic impairment
Risk of myopathy
Not for use in hamaturia of upper urinary tract origin unless benefits outweigh risks
Avoid rapid IV administration
Preservative benzyl alcohol linked to fatal "Gasping Syndrome" in premature neonates
Muscle weakness (milde myalgias and fatigue to severe myopathy with rhabdomyolysis and acute renal failure reported with prolonged use
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Not known whether excreted in breast milk, use caution
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.
Mechanism of Action
Inhibits fibrinolysis through inhibition of plasminogen binding to fibrin and subsequent conversion to plasmin, which in turn inhibits fibrinolysis
Exhibits antiplasmin activity
Onset: 1-72 hr
Duration: 3-4 hr (after 1 dose)
Half-Life: 2 hr
Vd: 23 L (PO), 30 L (IV)
Metabolites: Adipic acid
Clearance: 169 mL/min
Time to peak: Within 2 hr (PO)
Excretion: urine (65%)
Dialyzable: HD: yes
Solution: D5W, NS, Ringer's
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
Store between 15-30°C (59-86°F)
Do not freeze
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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.