aminocaproic acid (Rx)

Brand and Other Names:Amicar
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 250mg/mL

syrup

  • 1.25g/5mL

tablet

  • 500mg
  • 1,000mg
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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

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

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

Dosage Forms & Strengths

injectable solution

  • 250mg/mL

syrup

  • 1.25g/5mL

tablet

  • 500mg
more...

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

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Interactions

Interaction Checker

and aminocaproic acid

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

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            Adverse 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

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            Warnings

            Contraindications

            DIC

            Evidence of active intravascular clotting process

            Cautions

            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

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            Pregnancy & 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.

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            Pharmacology

            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

            Pharmacokinetics

            Onset: 1-72 hr

            Duration: 3-4 hr (after 1 dose)

            Half-Life: 2 hr

            Vd: 23 L (PO), 30 L (IV)

            Metabolism: Liver

            Metabolites: Adipic acid

            Clearance: 169 mL/min

            Time to peak: Within 2 hr (PO)

            Excretion: urine (65%)

            Dialyzable: HD: yes

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            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

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            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.

            Tier Description
            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.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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