Which medications in the drug class Antifibrinolytic Agents are used in the treatment of Disseminated Intravascular Coagulation (DIC)?

Updated: Dec 06, 2020
  • Author: Marcel M Levi, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

Antifibrinolytic Agents

In general, antifibrinolytic agents should be avoided in DIC because they are known to produce thrombotic complications, such as myocardial infarction and renal artery thrombosis when there is systemic clotting. They may have a role in a local intravascular coagulation (LIC) as is seen in genitourinary bleeding after a transurethral resection for Kasabach-Merritt syndrome.

In addition, in patients with trauma and massive bllood loss, antifibrinolytic agents have been shown to be effective in reducing blood loss and improving survival. Similarly, in massive postpartum hemorrhage, antifibrinolytic agents have been shown to be effective. Antifibrinolytics also may be useful in cases of DIC secondary to hyperfibrinolysis associated with acute promyelocytic leukemia and other forms of cancer when alpha-2-antiplasmin is uniquely decreased.

Aminocaproic acid (Amicar)

Aminocaproic acid inhibits fibrinolysis by inhibiting plasminogen activators and, to a lesser degree, exerting antiplasmin activity. The main problem is that the thrombi that form during treatment are not lysed and that the clinical significance of reducing bleeding is uncertain.

Tranexamic acid (Cyklokapron, Lysteda)

Tranexamic acid is used as an alternative to aminocaproic acid. It inhibits fibrinolysis by displacing plasminogen from fibrin.


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