EPSILON AMINOCAPROC ACID "EACA"
(for veterinary information only)
BRAND NAME: AMICAR
EACA is an “antifibrinolytic.” This means that EACA interferes with the body’s natural mechanisms for removing blood clots; in other words, it makes blood clots last longer. This comes into play in two situations: greyhounds and other sighthounds having surgery and in acute trauma cases where there is heavy blood loss. In the greyhound situation, there seems to be an issue where clots are dissolved prematurely, leading to bleeding from an incision site 2-3 days after an otherwise routine surgery. In the trauma situation, after a large amount of bleeding, natural factors that stabilize clots can be depleted and a little help is needed. This medication is usually given as an injectable in the hospital situation but there are oral forms that can be used in the home setting.
HOW THIS MEDICATION IS USED
EACA can be used as an oral medication pre or post-operatively to discourage bleeding or as an intravenous infusion before or after surgery to discourage excessive bleeding. EACA may be used in the treatment of spontaneously bleeding tumors (such as hemangiosarcoma) as well. It is also being investigated for treatment of spontaneously bleeding in patients with immune-mediated thrombocytopenia (platelet destruction).
Oral EACA is typically given 2-3 times daily and may be given with or without food. Store the product at room temperature, protected from light. If a compounded (custom made) formulation is used, follow the instructions provided by the pharmacy. If a dose is accidentally skipped, do not double up on the next dose but simply give the dose when it is remembered and time the next dose accordingly.
Approximately 1% of patients report upset stomach with this medication. Long term use has been associated with muscle damage in some cases so monitoring tests may be recommended.
INTERACTIONS WITH OTHER DRUGS
Patients taking estrogens may have an increased tendency for abnormal clotting, though this rarely is an issue at the low doses used in small animal medicine. Estrogens used in veterinary medicine include: DES and estriol.
CONCERNS AND CAUTIONS
DEGENERATIVE SPINAL DISEASE
EACA first became of interest in veterinary patients when work at the University of Florida suggested it would be helpful in slowing the progress of Degenerative Myelopathy in German shepherd dogs. Affected dogs develop neurologic weakness in their rear legs which progresses inexorably up the spinal cord to the front legs and ultimately to the respiratory muscles leading to death. The theory was that the neurodegeneration of this disease involves tiny bleeds in the spinal cord and that EACA might mitigate bleeding damage. Alternatively, EACA might inhibit other protein dissolving enzymes that could be disrupting the protective myelin of the spinal cord. Success of this therapy has not panned out but, as there is no other effective therapy for this condition, EACA is still sometimes recommended. Long term use is required and side effects are unusual, suggesting that, at the very least, this therapy does not cause any harm.
Page posted: 7/21/3013