Amicar (Aminocaproic acid is the generic name)

So, I have chosen the watch and see treatment (current count 30K) - with that my new Hemo has prescribed Amicar (Aminocaproic acid is the generic name) and asked that I keep it on hand and call first if I have a bleed.

My questions - has anyone here had to use it? - how fast did it work? - side effects?

I have been fortunate and never had a bleed - don't want one either :huh: but better to be prepared if I do.

Cindy Ann

Cindy Ann,

I have looked it up. Here are the side effects:

Its side effects include nausea, vomiting, and chronic mild fevers (37.2 to 37.8 °C). When used long-term (for approximately 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 generalized 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.

Here is the rest of the article:

Aminocaproic acid (also known as Amicar, ε-aminocaproic 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, and it 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[edit]

Aminocaproic acid is used to treat excessive postoperative bleeding, especially after procedures in which a great amount of bleeding is expected, 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.


I found a couple of articles. I would bet Sandi knows about it. I know nothing other than what I just read.

Jeffrey

No, I don't really know all that much about it. I asked my hemo if I could have it once to get some dental work done and he said no. I should have asked why but didn't.

It isn't prescribed for ITP very often which seems odd, so I'd guess there is a reason. If it was such a great thing, I would think more people would have it as a precaution. That is actually a good question to be asked at the conference, if anyone is going and thinks of it.

Just guessing, but probably the concern is increased risk of thrombosis with this drug combined with increased risk of thrombosis with ITP.

Sandi wrote: No, I don't really know all that much about it. I asked my hemo if I could have it once to get some dental work done and he said no. I should have asked why but didn't.

It isn't prescribed for ITP very often which seems odd, so I'd guess there is a reason. If it was such a great thing, I would think more people would have it as a precaution. That is actually a good question to be asked at the conference, if anyone is going and thinks of it.

I am still thinking of going. Not sure yet...

Rob - that is a very good answer and may even be correct, but a lot of hemo's do not even know that ITP sometimes carries a risk of thrombosis. That is pretty new research that a lot of people are not yet aware of. I see so many people being over-treated....such as treatment to prevent drops - unreal! However, that would be a very good reason for not prescribing it since a patient may misunderstand a symptom and take it with a good count.

Cindy Ann - do not let this scare you. I'm sure you will be responsible and use only if necessary.

Jeffrey - if you do go, maybe you could ask that question. If not, we'll find someone.

My son, he is 8, takes Amicar for bleeding and I have not seen any side effects. He has been taking it for 7 months. I think he takes a high dose, and has to take it 4 times a day during low platelets with bleeding.

It encourages clotting, so can present a fix for the bleeder, but a worry for the clotter. It was prescribed for my daughter after some major dental work, but she was also on bc pills to stop her periods. When I called back to the hematologist to point that out, having realized the clotting risks of the two drugs combined, but only after filling it at a cost of $200, he said she should not take it. Expensive mistake on our part, but glad it dawned on me in time.
Norma

Good catch Norma!

Thank you all for great feedback!

I am told to have it on hand and "if" I have a bleed I have to call my hemo first and then take it if she says so.

I have read a lot about it and it warrants caution when taking - don't want to stop the bleed just to clot

Cindy Ann

Is Amicar ever used when one is having a massive nosebleed? No one has suggested it to me.

I believe it is one of the "Bleeds" my Hemo will have me take it for based on my conversations with her. It will have to be real bad thou.

Cindy Ann

So I'm posting a link to a video on youtube it describes how are clots are formed if you are injured. In the video it talks about fibrinogen which is what the drug Amicar helps to activate. So amicar will basically help body to form more fibrinogen to keep the clot forming after surgery. To promote wound healing. This is also the reason it is not widely handed out to people ITP. Because platelets are just one of the factors that deal with clotting. It is a process that works like a cascade 1 thing activates another and so on.



www.youtube.com/watch?v=sZakNWRgw64




PS: Just clarify this video is a simple form there is a lot more to clotting but it helps to better understand it.

This second video there is a part where it shows a chart with all the factors of clotting.



www.youtube.com/watch?v=xNZEERMSeyM

Good videos, Julia! There is a whole process to clotting which is pretty complex. I've read that many doctors do not even understand the clotting process.

I still don't and one of my major project's was DIC (disseminated intravascular coagulation) sorry for the spelling. Basically you clot and bleed simultaneously. So I had to be well versed in it and we were not supposed to simplify it because quote "your presenting in front of professionals".