Aminocaproic

Aminocaproic acid, or epsilon-aminocaproic acid (EACA), is a synthetic amino acid analog used as an antifibrinolytic agent to reduce bleeding by limiting the breakdown of clots.

It acts as a competitive inhibitor of plasminogen activation and plasmin, blocking the lysine-binding sites that plasminogen uses to bind to fibrin. This slows fibrinolysis and helps stabilize formed clots.

It is employed to control bleeding from hyperfibrinolysis associated with surgery or trauma, to reduce bleeding during dental extractions in patients with bleeding disorders, and in some hematologic conditions where fibrinolysis is excessive. It may be used as an adjunct to other hemostatic measures or factor replacement therapy.

Aminocaproic acid is available in oral and parenteral forms. IV administration is common for acute bleeds; oral dosing is used for ongoing management or prophylaxis as directed. It is primarily excreted by the kidneys, and renal impairment can prolong its half-life, necessitating dose adjustments.

The most frequent adverse effects are gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal cramps, along with injection-site reactions. Thromboembolic events, hypersensitivity reactions, and rare anaphylaxis have been reported, particularly in patients with risk factors for thrombosis. It should be used with caution in patients with a history of thrombosis or in settings with disseminated intravascular coagulation.

Concomitant use with other prothrombotic therapies or agents that impair fibrinolysis can increase thrombotic risk. Caution is advised when estrogen-containing therapies are used concurrently.

Aminocaproic acid is available by prescription and is marketed under various brand names, including Amicar. It remains an alternative antifibrinolytic to tranexamic acid in appropriate cases.