Aminocaproic Acid
Aminocaproic acid is used for selected hyperfibrinolytic bleeding. Historical degenerative-myelopathy protocols have not shown established clinical benefit.
Group
Antifibrinolytic; lysine analogue
Mechanism of Action
Inhibits plasminogen activation and fibrin breakdown.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Hyperfibrinolytic haemorrhage | 50–100 mg/kg | IV, PO | Every 6 h | Anecdotal source range; a separate haemostasis reference describes 50 mg/kg every 6-8 hours. Select a regimen from measured bleeding response. |
| Degenerative myelopathy – historical adjunct | 500 mg/animal | PO | Every 8 h | Historical adjunct, often with acetylcysteine and vitamins. No treatment benefit was demonstrated in the cited controlled clinical evidence; not an established disease-modifying treatment. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Investigational antifibrinolysis | 70 mg/kg | IV | Once | Pharmacokinetic study administered over 20 minutes; an ensuing 15 mg/kg/hour infusion was proposed rather than established as a clinical standard. |
| Investigational antifibrinolysis — Maintenance | 15 mg/kg/hour | IV | Continuous | Proposed pharmacokinetic maintenance after the 70 mg/kg over-20-minute dose; not a validated efficacy protocol. |
Indications
- Hyperfibrinolytic haemorrhage
- Selected postoperative bleeding risk
Contraindications
- Active intravascular clotting or uncontrolled thrombotic disease.
- Use cautiously with renal, cardiac or hepatic disease.
Interactions
- Oestrogens or other procoagulants may increase thrombotic risk.
- Avoid duplicative antifibrinolytic treatment with tranexamic acid.
Adverse effects
- Gastrointestinal upset; hyperkalaemia may occur with renal impairment.
- Rapid/excessive IV exposure may cause hypotension or neurologic effects.
Toxicity
Stop exposure and support the patient; seizures are possible with marked overdose. The drug can be removed by dialysis.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Aminocaproic acid 500 mg tablet | Tablet | 500 mg / tablet | PO |
| Aminocaproic acid 1000 mg tablet | Tablet | 1000 mg / tablet | PO |
| Aminocaproic acid oral solution 250 mg/mL | Oral Liquid | 250 mg / mL | PO |
| Aminocaproic acid injection 250 mg/mL | Injection | 250 mg / mL | IV |
Monitoring and Administration
Assess bleeding mechanism, renal function and potassium; antifibrinolytic therapy does not replace surgical haemostasis or needed blood products.
Dilution for IV use may employ saline, D5W or Ringer solution where compatible with the actual formulation; avoid rapid administration.
Protect liquid products from freezing and store as specified; aldehydes/aldehydic sugars can cause discoloration.