Classifications: coagulator, hemostatic, systemic; Therapeutic:antihemorrhagic; antifibrinolytic
Pregnancy Category: C
250 mg/mL injection
500 mg tablets; 250 mg/mL syrup
Synthetic hemostatic with specific antifibrinolysis action. Inhibits plasminogen activator substance, and to a lesser degree
plasmin (fibrinolysin), which is concerned with destruction of clots.
Acts as an inhibitor of fibrinolytic bleeding.
To control excessive bleeding resulting from systemic hyperfibrinolysis; also used in urinary fibrinolysis associated with
severe trauma, anoxia, shock, urologic surgery, and neoplastic diseases of GU tract.
To prevent hemorrhage in hemophiliacs undergoing dental extraction; as a specific antidote for streptokinase or urokinase
toxicity; to prevent recurrence of subarachnoid hemorrhage, especially when surgery is delayed; for management of amegakaryocytic
thrombocytopenia; and to prevent or abort hereditary angioedema episodes.
Severe renal impairment; active disseminated intravascular clotting (DIC); upper urinary tract bleeding (hematuria); hemophilia;
benzyl alcohol hypersensitivity, especially in neonates; paraben hypersensitivity; pregnancy (category C); lactation.
Cardiac, renal, or hepatic disease; renal impairment; history of pulmonary embolus or other thrombotic diseases; hypovolemia.
Route & Dosage
Adult: PO/IV 45 g during first hour, then 11.25 g qh for 8 h or until bleeding is controlled (max: 30 g/24h)
Child: PO/IV 100 mg/kg or 3 g/m2 during first hour, then 33.3 mg2/kg qh (max: 18 g/m2/24 h)
Reduce dose to 1525% of normal dose.
- Note: May need to give patient as many as 10 tablets or 4 tsp for a 5 g dose during the first hour of treatment (each tablet contains
500 mg, syrup contains 250 mg/mL).
PREPARE: IV Infusion: Dilute parenteral aminocaproic acid before use. Each 4 mL (1 g) is diluted with 50 mL of NS, D5W, or RL.
ADMINISTER: IV Infusion: ?? Physician orders specific IV flow rate.??Usual rate is 5 g or a fraction thereof over first hour (5 g/250 mL).??Give each additional gram over 1 h. Avoid rapid infusion to prevent hypotension, faintness, and bradycardia or other arrhythmias.
INCOMPATIBILITIES Solution/additive: Fructose solution.
- Store in tightly closed containers at 15°30° C (59°86° F) unless otherwise directed. Avoid
Adverse Effects (≥1%)CNS:
, headache, seizures. CV:
Faintness, orthostatic hypotension; dysrhythmias; thrombophlebitis, thromboses. Special Senses:
Tinnitus, nasal congestion. Conjunctival erythema
Nausea, vomiting, cramps, diarrhea
, anorexia. Urogenital:
Diuresis, dysuria, urinary frequency, oliguria, reddish-brown urine (myoglobinuria), acute renal failure.
Prolonged menstruation with cramping. Skin:
Diagnostic Test Interference
Serum potassium may be elevated (especially in patients with impaired renal function).
, oral contraceptives
may cause hypercoagulation.
Rapidly from GI tract. Peak:
2 h. Distribution:
Readily penetrates RBCs and other body cells. Elimination:
80% as unmetabolized drug in 12 h.
Assessment & Drug Effects
- Check IV site at frequent intervals for extravasation.
- Observe for signs of thrombophlebitis. Change site immediately if extravasation or thrombophlebitis occurs (see Appendix
- Monitor & report S&S of myopathy: muscle weakness, myalgia, diaphoresis, fever, reddish-brown urine (myoglobinuria), oliguria,
as well as thrombotic complications: arm or leg pain, tenderness or swelling, Homan's sign, prominence of superficial veins,
chest pain, breathlessness, dyspnea. Drug should be discontinued promptly.
- Monitor vital signs and urine output.
- Lab tests: with prolonged therapy, monitor creatine phosphokinase activity and urinalyses for early detection of myopathy.
Patient & Family Education
- Report difficulty urinating or reddish-brown urine.
- Report arm or leg pain, chest pain, or difficulty breathing.