A comparison of two dose regimens of epsilon aminocaproic acid in the prevention and management of secondary traumatic hyphemas.
Fifty-nine patients who sustained hyphema following blunt trauma were randomly assigned prospectively to either of two dose regimens of epsilon aminocaproic acid (Amicar). Twenty-six took an oral dosage of 50 mg/kg ("half dose") every four hours for five days, up to a maximum of 30 g/day, and 33 patients received 100 mg/kg ("full-dose") every four hours up to a maximum of 30 g/day. Five patients in the full-dose group experienced dizziness, hypotension, and syncope. Half-dose Amicar substantially reduced such serious side effects (P = 0.063), had no adverse effect on the reduced rate of recurrent hemorrhages (P = 0.22), and was more cost effective than the full-dose regimen. When the two patients in the half-dose group receiving 30 g/day of Amicar were deleted, however, the comparison of dizziness and hypotension in the two groups became more significant (P = 0.050). The incidence of nausea and vomiting was approximately the same in both groups (P = 0.52). Serum Amicar levels were within the range of plasminogen inhibition at both dose levels. Prior aspirin ingestion appeared to have no influence on the rate of rebleeding (P = 0.58).
D000287:Administration, Topical; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000614:Aminocaproates / Q000008:administration & dosage*; D015119:Aminocaproic Acid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004244:Dizziness / Q000139:chemically induced; D005131:Eye Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D006988:Hyphema / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control* / Q000601:surgery; D007022:Hypotension / Q000139:chemically induced; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D012008:Recurrence; D014949:Wounds, Nonpenetrating / Q000150:complications*
D000305:Adrenal Cortex Hormones; D000614:Aminocaproates; D015119:Aminocaproic Acid