What is the role of aminocaproic acid in the management of complications from thrombolytic therapy?

Updated: Dec 31, 2017
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Answer

Aminocaproic acid is a specific antidote to fibrinolytic agents. In adults, 4-5 g of aminocaproic acid in 250 mL of diluent is administered by infusion during the first hour of treatment, followed by a continuing infusion at the rate of 4 mL (1 g) per hour in 50 mL of diluent. Infusion is continued for about 8 hours or until the bleeding situation has been controlled. [68]  Fresh frozen plasma, cryoprecipitate, or both may be used to replenish fibrin and clotting factors.

Aminocaproic acid should not be given unless hemorrhage is life-threatening, because it inhibits intrinsic fibrinolytic activity and can precipitate runaway thrombosis with end-organ damage at many sites. The drug worsens disseminated intravascular coagulation (DIC), including that associated with heparin-induced thrombocytopenia.


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