Alternate Name(s):
CYKLOKAPRON®
Classification:
Antifibrinolytic Agent
Original Date:
August 2005
Revised Date:
October 2024
Indications:
- Used to prevent excessive bleeding when hyperfibrinolysis is present
- Tooth extraction in hemophiliacs (in combination with antihemophiliac factor)
- Bleeding after surgical procedures such as tonsillectomy and adenoidectomy
- Management of massive bleeding
Reconstitution and Stability:
- Available as a 100 mg/mL injection
- Stable at room temperature
Compatibility:
- Solutions Compatible: D5W, 0.9%NS, dextrose-saline combinations
- Incompatible: penicillin
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct | YES Usual dilution: 100 mg/mL Infusion time: 5 - 10 minutes Infusion rate: do not exceed 100 mg/minute |
| IV Intermittent Infusion | YES Usual dilution: 10 mg/mL Infusion time: 15-30 minutes Infusion rate: do not exceed 100 mg/minute |
| IV Continuous Infusion |
YES - in ED or PICU Usual dilution: 10 mg/mL, 100 mg/mL |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Pediatric:
- Prior to procedure or Dental surgery :
- 7-10 mg/kg/dose IV pre-procedure and then TID-QID until able to take oral medication
- Cardiac surgery:
- 50-100 mg/kg IV at beginning of procedure
- Infusion of 10 mg/kg intraoperatively has been used
- Code Transfusion (massive hemorrhage):
| Age | Loading dose | Infusion* over 8 hours |
| < 13 years | 15 mg/kg IV bolus (max 1000mg) | 5 mg/kg/hr (max 125mg/hr) |
|
≥ 13 years |
1000mg IV bolus | 1000mg total (125mg/hr) |
| Catastrophic bleeding (regardless of age) | 30 mg/kg IV bolus (max 2000mg) | 10 mg/kg/hr (max 250 mg/hr) |
*If there are issues with infusion (pump availability, program or line issues) give bolus dosing with repeat after 1hr if ongoing bleeding
DOSING ADJUSTMENT IN RENAL IMPAIRMENT:
|
Renal Impairment |
Dose |
|
Mild |
Change interval to Q12h or give 50% of standard dose |
|
Moderate |
Change interval to Q24h or give 25% of standard dose |
|
Severe |
Change interval to Q48h or give 10% of standard dose |
Potential hazards of parenteral administration:
- Hypotension with rapid IV
- Nausea, vomiting, diarrhea and abdominal pain (more common with oral therapy)
- CNS effects such as headache and hydrocephalus
- Coagulation defects
- Thromboembolic complications are infrequent
- Visual abnormalities
Notes:
- Contraindicated in subarachnoid hemorrhage, acquired defective colour vision, active intravascular clotting process
- Use with caution in renal impairment
- Opthalmologic exams during chronic therapy (e.g. several weeks of therapy)