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Anti-fibrinolytics

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Tranexamic acid
  • include ε aminocaproic acid, tranexamic acid and aprotonin
  • reduce breakdown of blood clots
  • appear to decrease bleeding after cardiac surgery
    • use of aprotonin is associated with a higher mortality compared to ε aminocaproic acid and tranexamic acid
  • reduce rebleeding and death after GI bleeding, but role in relation to endoscopic therapy and proton pump inhibitors is unknown
  • complications include thrombosis and possible increased risk of death with aprotonin

Further reading

Mangano DT, Miao Y, Vuylsteke A et al. Mortality associated with aprotinin during 5 years following coronary artery bypass graft surgery. JAMA 2007; 297: 471–479.

Tinmouth AT et al. Blood conservation strategies to reduce the need for red blood cell transfusion in critically ill patients. CMAJ 2008;178(1):49-57

Schneeweiss S et al. Aprotinin during coronary-artery bypass grafting and risk of death. N Engl J Med 2008; 358: 771–783

Shaw AD. The effect of aprotinin on outcome after coronary-artery bypass grafting. N Engl J Med 2008; 358: 784–793


©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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