Drug reference

epsilon amino-caproic acid

Antifibrinolytic (lysine analogue) · Antifibrinolytic

START

4–5 g IV/PO first hour, then ~1 g/h until bleeding controlled

TYPICAL MAX

~30 g/24 h

STOP IF

Thrombosis, myopathy/rising CK, or renal obstruction

WATCH

CK (prolonged use), renal function, signs of thrombosis

CDSCO approvedATC B02AA01

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 15min · absorption
PEAK: 1.5h · Tmax
t½: 2h · t½
DURATION: 3h · needs re-dosing

EXCRETION

Renal — largely unchanged

route + CYP

INTERACTIONS

3 major

SEVERE in our sources

PREGNANCY

Use only if clearly needed; limited data.

FDA category + note

Top interactionssee all 5 →

Combined Hormonal ContraceptivesSevereDatabaseKimi deep-research + Cla
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TretinoinSevereDatabaseKimi deep-research + Cla

Mechanism

Competitively inhibits plasminogen activation (binds the lysine-binding site), preventing conversion to plasmin and stabilising fibrin clots — reduces fibrinolysis-mediated bleeding.

Indications

Bleeding from systemic hyperfibrinolysisBleeding in fibrinolytic-therapy overdoseAdjunct in haemophilia/mucosal bleeding (e.g., dental, prostatic surgery)Subarachnoid haemorrhage rebleed prevention (selected/historical)

Dosing

Adult: Acute bleeding: 4–5 g IV/PO in the first hour, then 1–1.25 g/h (or 1 g/h) for ~8 h or until controlled; max ~30 g/24 h.
Pediatric: 100 mg/kg (or 3 g/m²) initial, then 33 mg/kg/h (specialist).
Renal adjustment: Reduce dose substantially in renal impairment (renally excreted, accumulation).
Hepatic adjustment: No specific adjustment.
Geriatric: Caution; thrombosis/accumulation risk.
Max dose: ~30 g/24 h

Pharmacokinetics

Onset

Rapid (IV minutes)

Peak effect

~1–2 h (oral); IV rapid

Duration

~3 h (short — requires continued dosing)

Half-life

~2 h

Bioavailability

Well absorbed orally

Protein binding

Negligible

Metabolism

Minimal

Excretion

Renal (largely unchanged)

Contraindications

Active intravascular clotting / DIC (without concurrent heparin)
Evidence of active thromboembolic disease
Upper urinary tract bleeding (clot obstruction — relative)
Hypersensitivity

Side effects

Common

Nausea/vomitingDiarrhoeaHypotension (rapid IV)DizzinessNasal congestion

Serious

Thrombosis (venous/arterial)
Rhabdomyolysis/myopathy (prolonged high dose)
Renal failure (intrarenal clot, ureteral obstruction)
Severe hypotension/bradycardia (rapid IV)

Pregnancy & lactation

Pregnancy

Use only if clearly needed; limited data.

Lactation

Limited data; caution.

Drug interactions

Combined Hormonal Contraceptives

Severe

Database

Additive thrombotic risk

Avoid combination