Aminocaproic acid

Aminocaproic acid (also known as Amicar, ε-amino caproic acid, ε-Ahx, or 6-aminohexanoic acid) is a derivative and analogue of the amino acid lysine, which makes it an effective inhibitor for enzymes that bind that particular residue. Such enzymes include proteolytic enzymes like plasmin, the enzyme responsible for fibrinolysis. For this reason it is effective in treatment of certain bleeding disorders - especially fibrogenemia - and is marketed as Amicar. Aminocaproic acid is also an intermediate in the polymerization of Nylon-6, where it is formed by ring-opening hydrolysis of caprolactam.

Clinical use

Aminocaproic acid is used to treat excessive postoperative bleeding, especially after procedures in which a great amount of bleeding is indicated, such as cardiac surgery. It can be given orally or intravenously. A meta-analysis found that lysine analogs like aminocaproic acid significantly reduced blood loss in patients undergoing coronary artery bypass grafting.

Aminocaproic acid can also be used to treat the overdose and/or toxic effects of the thrombolytic pharmacologic agents tissue plasminogen activator (commonly known as tPA) and streptokinase.

Side-effects

Its side-effects include nausea, vomiting, and chronic mild fevers (99 degrees to 100 degrees). When used long-term (for approx. 6 to 12 months), there is a risk of the inflammation of one's internal organs, especially the appendix (appendicitis) and liver, as well as failure of the liver and cyanosis. It almost always causes generalised myalgia and fibromyalgia. In some cases, successive organ failure can occur after long-term usage. However, the main risk associated with aminocaproic acid is the increased risk for thrombosis because of the inhibition of fibrinolysis.