Comparative Pharmacology
Head-to-head clinical analysis: AMICAR versus TRASYLOL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMICAR versus TRASYLOL.
AMICAR vs TRASYLOL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Competitive inhibition of plasminogen activation, reducing fibrinolysis by blocking the binding of plasminogen to fibrin.
Aprotinin is a serine protease inhibitor that forms reversible enzyme-inhibitor complexes with trypsin, plasmin, kallikrein, and chymotrypsin, thereby inhibiting fibrinolysis and reducing perioperative blood loss.
4-5 g IV loading dose over 1 hour, followed by 1 g/hour IV continuous infusion for 8 hours or until bleeding controlled; oral: 5 g PO initially, then 1-1.25 g PO every hour as needed.
1,000,000 KIU (kallikrein inhibitor units) IV loading dose over 10 minutes, followed by 250,000 KIU/hour continuous IV infusion during surgery; also 1,000,000 KIU added to cardiopulmonary bypass circuit prime volume.
None Documented
None Documented
Terminal elimination half-life: 2 hours (range 1-3.5 hours). After high doses or renal impairment, half-life may prolong (up to 5-10 hours).
Terminal elimination half-life approximately 2 hours (alpha phase) and 10-12 hours (beta phase); prolongation in renal impairment.
Renal: >99% of absorbed dose excreted unchanged in urine. Biliary/fecal: negligible (<1%).
Primarily renal excretion; 70-80% of aprotinin is eliminated unchanged in urine within 48 hours; minor biliary/fecal elimination (<5%).
Category C
Category C
Antifibrinolytic
Antifibrinolytic