What is the role of fibrinolytic inhibitors in the treatment of factor IX deficiency (FIX) (hemophilia B)?

Updated: Mar 09, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Srikanth Nagalla, MD, MS, FACP  more...
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Answer

Fibrinolytic inhibitors are used as follows:

  • A dose of EACA, 5 g orally or IV, is administered immediately before the surgical procedure along with a dose of FIX, followed by 1 g per hour postoperatively until the decision is made to taper the dose over the next 5 days.

  • Tranexamic acid can be administered in a dose of 1.5 g every 6-8 hours for 5 days; this drug is not available in the United States.

  • Administration of these fibrinolytic inhibitors is contraindicated in patients with hematuria who are receiving or have recently received an FIX product because of the risk of an acute persistent thrombus obstructing the ureters and causing acute hydronephrosis.


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