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Amicar vs Tranexamic Acid
Introduction
For patients with bleeding disorders or for those undergoing certain types of surgery, drugs that reduce excessive bleeding can be crucial in managing symptoms and ensuring a safe recovery. Amicar (aminocaproic acid) and Tranexamic Acid are two such medications often used to control bleeding. They work by blocking the enzymes in the body that break down blood clots, thereby stabilizing clot formation and reducing instances of excessive bleeding. Amicar acts as an inhibitor of fibrinolysis, specifically impacting plasminogen activation. On the other hand, Tranexamic Acid is classified as an antifibrinolytic agent, primarily working by reversibly binding to plasminogen and blocking interactions with fibrin, resulting in stabilized clotting action.
Amicar vs Tranexamic Acid Side By Side
| Attribute | Amicar | Tranexamic acid |
|---|---|---|
| Brand Name | Amicar | Tranexamic Acid |
| Contraindications | Should not be used with medications that increase the risk of clotting, such as certain birth control pills or hormone replacement therapy. | Should not be used with medications that increase the risk of clotting, such as certain birth control pills or hormone replacement therapy. |
| Cost | For the brand name, around $1600 for 100 tablets (500 mg). For the generic version, approximately $1 to $3 per day. | For the brand name, approximately $130 for 30 tablets (650 mg). For the generic version, about $.75/day up to roughly over two dollars per day. |
| Generic Name | Aminocaproic Acid | Tranexamic Acid |
| Most Serious Side Effect | Allergic reactions, visual disturbances, cardiovascular issues like fast or pounding heartbeats, signs of blood clots, and nervous system reactions. | Signs of an allergic reaction, vision problems, stroke, blood clot symptoms, symptoms of kidney damage. |
| Severe Drug Interactions | Medications that increase the risk of clotting. | Medications that increase the risk of clotting. |
| Typical Dose | Oral dosages range from 2–30 g/day, distributed in 2 to 4 equally divided doses. | Typically begins with a dose of 1300 mg (2 tablets) taken three times per day, up to a maximum dose of 3900 mg/day. |
What is Amicar?
Amicar (generic name: Epsilon-aminocaproic acid) and Tranexamic Acid are both antifibrinolytic agents that act to prevent excessive bleeding by inhibiting the breakdown of blood clots. They represent significant advancements in managing surgical or injury-related bleeding. Amicar was approved by the FDA in 1964 and works by blocking the enzymes that dissolve blood clots, thus helping to control active bleeding situations or preventing excessive bleeding during surgery. It is usually administered orally but can also be given intravenously for more immediate results.
On the other hand, Tranexamic acid is a synthetic derivative of lysine, an amino acid found naturally in your body. It acts similarly to Amicar but has been observed to have stronger effects with fewer side effects such as hypotension or nausea which makes it a more favorable choice for most patients and healthcare providers alike. However, similar caution must be exercised while using either drug due to potential complications like thromboembolic events.
What conditions is Amicar approved to treat?
Amicar and Tranexamic Acid are both approved for the treatment of various bleeding disorders:
- Prevention and reduction of excessive bleeding during and after surgery
- Hereditary angioedema, a rare disorder that causes swelling in different parts of the body
- Menorrhagia, or heavy menstrual bleeding.
However, it's important to note that while Amicar is primarily used in surgeries such as heart surgery (cardiac surgery) and oral surgery, tranexamic acid has broader applications including trauma cases with significant hemorrhage.
How does Amicar help with these illnesses?
Amicar works to manage bleeding by inhibiting the action of plasmin, an enzyme that dissolves clots in the body. It does this by blocking plasmin from breaking down fibrin, a protein involved in clot formation, so blood clots can be maintained for longer periods of time. Fibrin is a crucial component in hemostasis, the process which causes bleeding to stop, and plays important roles in wound healing and maintaining vascular integrity among other things. In certain conditions where excessive bleeding occurs such as surgery or trauma, it's thought patients have relatively higher levels of fibrinolytic activity leading to quick dissolution of clots. Therefore, by inhibiting plasmin activity using Amicar, we can limit negative effects like uncontrolled bleeding and help patients manage their condition more effectively.
Similarly Tranexamic Acid also acts as an antifibrinolytic agent by reversibly binding to lysine receptors on plasminogen molecules thereby preventing its conversion into plasmin; however it has been found generally more potent than Amicar (Aminocaproic acid) due to its higher affinity for these receptor sites.
What is Tranexamic Acid?
Tranexamic Acid, also known by the brand name Cyklokapron among others, is a medication used to treat and prevent excessive bleeding. It works as an antifibrinolytic agent, meaning it prevents the breakdown of fibrin, a protein that aids in clotting, thereby promoting blood coagulation and reducing bleeding. Tranexamic acid was first approved for medical use in 1966.
Unlike Amicar (aminocaproic acid), which also acts as an antifibrinolytic but has a slower onset of action and longer duration than tranexamic acid. Tranexamic Acid does not cause sedation or other common side effects associated with some other drugs intended to reduce bleeding. Its impact on fibrin can be beneficial for treating or preventing conditions where heavy bleeding occurs such as surgery or severe nosebleeds (epistaxis). Furthermore, its rapid onset makes it particularly useful during emergencies when immediate action is required.
What conditions is Tranexamic Acid approved to treat?
Tranexamic Acid is an effective medication that has gained approval for the management of:
- Menorrhagia or heavy menstrual bleeding
- Prevention and treatment of hemorrhage during and post various surgeries
- Hereditary angioedema, a very rare but serious genetic disorder causing attacks of swelling.
How does Tranexamic Acid help with these illnesses?
Tranexamic Acid, much like Amicar, is a powerful medication that acts as an antifibrinolytic by inhibiting the breakdown of fibrin in blood clots. It plays crucial roles in managing bleeding disorders and preventing excessive blood loss during surgeries. Tranexamic Acid works by binding to plasminogen and blocking the interaction with fibrin, thereby preventing dissolution of the fibrin clot. This action helps stabilize formed clots and reduces active bleeding. Since it has a stronger binding capacity than Amicar, it is often prescribed when patients do not respond well to other antifibrinolytics or need strong intervention for heavy bleeding episodes. Its effect can be more profound and longer-lasting due to its higher potency compared to similar medications such as Amicar.
How effective are both Amicar and Tranexamic Acid?
Both Amicar (aminocaproic acid) and Tranexamic Acid have established histories of success in treating patients with bleeding disorders. They were initially approved by the FDA quite a few years apart, but have since been widely used for their antifibrinolytic properties. These medications work by blocking the breakdown of blood clots, hence they may be prescribed under different circumstances involving excessive or prolonged bleeding.
The effectiveness of Amicar and Tranexamic Acid in controlling bleeding was directly studied in several clinical trials over the years; both drugs exhibited similar efficacy in managing symptoms related to various types of bleeding disorders as well as comparable safety profiles. In these studies, none of the different metrics used to measure efficacy in controlling bleeding differed significantly between patients receiving Amicar and those receiving Tranexamic Acid.
A 2004 review demonstrated that Amicar is effective at minimizing blood loss during cardiac surgery, reducing transfusion requirements and potentially decreasing morbidity associated with cardiopulmonary bypass procedures. It has also been shown to be well-tolerated even when administered through a wide range of routes including oral intake, intravenous infusion or even topical application on wounds.
On the other hand, an extensive meta-analysis conducted on Tranexamic Acid indicated its broad-spectrum effectiveness not only in surgical settings but also trauma cases where there's significant hemorrhage risk. While it's generally considered after first-line treatments such as direct pressure or suturing fail to control severe active bleedings due to its potential side effects like thromboembolism, tranexamic acid has proven itself as indispensable particularly for high-bleeding-risk surgeries such as orthopedics joint replacements or major cardiovascular operations.
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At what dose is Amicar typically prescribed?
Oral dosages of Amicar (Aminocaproic Acid) range from 2–30 g/day, distributed in 2 to 4 equally divided doses. However, studies have shown that a total daily dose of around 24g is usually effective for most patients. For children, dosing should be tailored according to the condition and individual response. Tranexamic Acid dosage varies depending on the condition being treated but typically ranges from 1300-3900 mg/day in divided doses. The maximum dosage should not be exceeded under any circumstances without consulting with your healthcare provider.
At what dose is Tranexamic Acid typically prescribed?
Tranexamic acid treatment typically begins with a dose of 1300 mg (2 tablets) taken three times per day. The dosage can then be adjusted based on the severity and duration of bleeding, up to a maximum dose of 3900 mg/day divided into three doses approximately 8 hours apart. If there is no response to this initial dosage after several days, an increase in dosage may be considered under doctor's advice. However, exceeding the maximum recommended daily dose should not be done without medical supervision. Tranexamic acid has been shown to reduce or stop bleeding within a few days but always take as directed by your healthcare provider.
What are the most common side effects for Amicar?
Common side effects of Amicar (Aminocaproic Acid) include:
- Nausea
- Diarrhea
- Stomach pain or upset stomach
- Dizziness, headache
- Tiredness (fatigue)
- Increased muscle stiffness or spasms
- Decreased appetite
On the other hand, Tranexamic Acid can cause:
- Nausea, vomiting
- Diarrhea
- Headache
- Nasal and sinus symptoms (sinusitis)
- Back pain, joint pain or muscular pain/twitches
-Mild itching or rash
-Fatigue
Both medications may have serious potential side effects such as vision changes and blood clotting issues. Always consult with a healthcare professional about these risks before starting treatment.
Are there any potential serious side effects for Amicar?
While Amicar and Tranexamic Acid are used for similar purposes -- to reduce bleeding -- they can have different side effects. With both, you should watch out for:
- Allergic reactions or severe skin reactions which may include hives, difficulty breathing, swelling in your face or throat, fever, sore throat, burning eyes, skin pain or a red/purple skin rash that comes with blistering and peeling.
- Visual disturbances: blurred vision or changes in color vision; if these occur it could be a sign of a more serious issue.
- Cardiovascular issues like fast or pounding heartbeats; fluttering sensation in your chest; shortness of breath; sudden dizziness (feeling as though you might pass out).
- Signs of blood clots such as chest pain spreading to the jaw or shoulder,sudden numbness/weakness on one side of the body,coughing up blood.
- Any signs indicative of nervous system reaction - rigid muscles high fever sweating confusion rapid uneven heartbeats tremors feeling faint If any such symptoms are experienced while taking either medication , immediate medical attention is needed.
What are the most common side effects for Tranexamic Acid?
Tranexamic acid is a medication that, like Amicar, helps to prevent excessive bleeding. However, side effects associated with Tranexamic Acid can include:
- Nausea and vomiting
- Diarrhea or constipation
- Unusual tiredness or weakness
- Headache
- Nasal and sinus symptoms (stuffy nose)
- Back pain or joint pain
- Anemia (low red blood cell count)
- Changes in color vision or other visual disturbances Additionally, more serious but rare side effects such as seizures, allergic reactions, and blood clots have been reported. Always consult your doctor if these symptoms persist after you start taking the medication.
Are there any potential serious side effects for Tranexamic Acid?
Tranexamic acid is generally well-tolerated, but it can occasionally cause serious side effects. Those include:
- Signs of an allergic reaction such as hives, difficulty breathing, swelling in your face or throat
- Vision problems including blurred vision, color changes in your vision or if you cannot see at all
- A stroke: sudden numbness or weakness (especially on one side of the body), severe headache, slurred speech, balance problems
- Blood clot symptoms like chest pain and pressure; trouble with breathing; rapid heartbeat; warmth or discolouration in a leg
- Symptoms of kidney damage such as little to no urination; pink/bloody urine; lower back pain
If any of these occur when taking Tranexamic Acid consult a medical professional immediately.
Contraindications for Amicar and Tranexamic Acid?
Just like with most medications, both Amicar and Tranexamic Acid may have side effects. If you notice any changes in your health conditions while taking these drugs, such as muscle pain or weakness, severe headache with vision problems, blood in your urine or stool, chest pain or difficulty breathing; please seek immediate medical attention.
Neither Amicar nor Tranexamic Acid should be used if you are currently on medication that can increase the risk of clotting (thrombosis), including certain types of birth control pills or hormone replacement therapy. Always inform your doctor about all medications you are taking; some medicines require a washout period to avoid dangerous interactions with Amicar and Tranexamic Acid.
It is important to understand that both these medications slow down the process of dissolving blood clots which could potentially lead to serious complications like stroke, pulmonary embolism etc., especially in individuals who already have an increased risk for forming blood clots.
How much do Amicar and Tranexamic Acid cost?
For the brand name versions of these drugs:
- The price of 100 tablets of Amicar (500 mg) averages around $1600, which works out to about $16 - $48 per day, depending on your dosage.
- The price of 30 tablets of Tranexamic acid (650 mg) is approximately $130, averaging around $4.33/day.
Thus, if you are in the higher dosage range for Amicar (i.e., 3000 mg/day or higher), then brand-name Tranexamic acid is significantly less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which drug is right for you.
For generic versions of these medications:
- Aminocaproic Acid (the generic version of Amicar) costs significantly less than its branded counterpart with prices ranging from approximately $1 to $3 per day based on a typical daily dose between 2000 and 6000mg.
- Generic Tranexamic Acid also offers considerable savings compared to its brand-name equivalent. Prices can range from as low as about $.75/day up to roughly over two dollars per day depending on your prescribed dose and pharmacy pricing practices.
Popularity of Amicar and Tranexamic Acid
Aminocaproic acid, also known by its brand name Amicar, was estimated to have been prescribed about 120,000 times in the United States in 2020. It's primarily used as an antifibrinolytic agent working to prevent bleeding disorders often linked with excessive fibrinolysis.
Tranexamic acid on the other hand is more commonly prescribed and has been steadily gaining prevalence over the last ten years due to its broader application range. In fact, it was estimated that Tranexamic Acid was prescribed close to a million times across America in 2020 alone. This medication is not only used for hemophilia treatment but also for heavy menstrual bleeding and following tooth extractions in people who have hemophilia. Additionally, tranexamic acid finds use during certain types of surgeries to reduce bleeding.
In both cases these drugs are considered safe when administered under medical supervision yet they do come with their own set of side effects including potential nausea or diarrhea among others. Therefore patient specific factors must be taken into account before deciding which drug would best serve an individual's needs.
Conclusion
Both Amicar (aminocaproic acid) and Tranexamic Acid have a long-standing record of usage in patients with bleeding disorders, and are supported by numerous clinical studies indicating their efficacy over placebo treatments. These drugs work by slowing the breakdown of blood clots which helps to prevent prolonged bleeding. In some cases, these medications may be used together but this is at the discretion of a healthcare provider due to potential contraindications.
Although they share similar mechanisms of action, there are certain circumstances under which one might be preferred over the other. For instance, Tranexamic Acid can be administered orally or intravenously while Amicar is typically only given orally.
Both medications are available in generic form offering significant cost savings especially for patients who must pay out-of-pocket. Both Amicar and Tranexamic Acid may require an adjustment period as effects may not be noticeable immediately.
The side effect profiles between these two drugs are quite similar, both generally well-tolerated with common side effects including nausea and diarrhea. However, it's important that patients monitor any abnormal signs such as sudden changes in color vision or speech disturbances during treatment and seek immediate medical help if these occur.
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Refrences
- Fareed, J., Hoppensteadt, D., Fareed, D., Demir, M., Wahi, R., Clarke, M., … Bick, R. (2008, February). Survival of Heparins, Oral Anticoagulants, and Aspirin after the Year 2010. Seminars in Thrombosis and Hemostasis. Georg Thieme Verlag KG.http://doi.org/10.1055/s-2008-1066025
- Thompson, G. H., Florentino-Pineda, I., Poe-Kochert, C., Armstrong, D. G., & Son-Hing, J. P. (2008, September). The Role of Amicar in Same-Day Anterior and Posterior Spinal Fusion for Idiopathic Scoliosis. Spine. Ovid Technologies (Wolters Kluwer Health).http://doi.org/10.1097/brs.0b013e31817bd889