Amicar
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Trade Name
Amicar, Aminocaporoic Acid
Mechanism
inhibits fibrinolysis via inhibition of TPA substances – promotes clot formation
Dosage
Half-life
- 2hrs
ECC Dosage
- Three doses - 30gm total
- Load Dose:5-10gm diluted given slowly IV 15-30 min prior to skin incision
- Pump dose:5-10gm added to prime Pre-CPBP
- Maintenance Dose: 5-10gm slowly IV post-protamine
- watch for reaction anaphylactic response which can inhibit the effects
Oral dosage
- Adults- 5g PO the first hour, followed by 1 to 1.25 g/hour PO for 8 hours or until bleeding is controlled. Max: 30 g/day.
- Children and Adolescents - 50 to 100 mg/kg/dose PO every 6 hours. Max: 24 g/day.
Intravenous dosage
- Adults - 4 to 5 g IV over 1 hour, followed by 1 g/hour continuous IV infusion for 8 hours or until bleeding is controlled. Max: 30 g/day.
- Children and Adolescents - 100 to 200 mg/kg IV, followed by 100 mg/kg IV every 6 hours. Max: 30 g/day. Alternatively, 100 mg/kg or 3 g/m2 IV, followed by 33.3 mg/kg/hour or 1 g/m2/hour continuous IV infusion, not to exceed 18 g/m2/day.
Indications
excessive bleeding from systemic fibrinolysis & urinary fibrinolysis
Action
Enhances hemostasis when fibrinolysis contributes to bleeding
Adverse Effects
- muscle weakness
- headache
- nausea
- vomiting
- stomach pain
- diarrhea
- stuffy nose
- watery eyes
- vision problems
- ringing in your ears
- itching
- rash
- decreased amount of semen when having an orgasm (in men)
Contraindications
DIC, blood clots, liver problems, decreased kidney function, bloody urine, increased creatine kinase levels
References
https://www.pdr.net/drug-summary/Amicar-aminocaproic-acid-1954.3768