Active Ingredients

Antifibrinolytics – Effect, Application & Risks

Antifibrinolytika

In pharmacology and human medicine, the term antifibrinolytics summarizes various active ingredients that lead to the dissolution of fibrin . As a result, antifibrinolytics prevent the occurrence of bleeding , which is why they are also referred to as bleeding or plasmin inhibitors.

Was sind Antifibrinolytika?

The active substance class of antifibrinolytics consists of the active substances tranexamic acid and aprotinin . While the latter constitutes a plasmin inhibitor, the former is considered an amino acid . Both have in common that they lead to an inhibition of bleeding. Antifibrinolytics are therefore also considered plasmin inhibitors or bleeding stoppers. They cause fibrin to be inhibited, resulting in increased blood clotting . The best-known antifibrinolytics include the preparations Cyklokapron® and Trasylol®.

Antifibrinolytics are typically taken orally. Intravenous administration is also possible. They are subject to pharmacy and prescription requirements, so they can only be obtained from a licensed pharmacy on the basis of a doctor’s prescription .

Pharmacological effect on body & organs

The mechanism of action of all antifibrinolytics is based on influencing the body’s own fibrin. This is the activated, cross-linked protein that is responsible for the plasmatic coagulation of human blood .Antifibrinolytics cause inhibition of plasmin after ingestion . This is the substance responsible for dissolving fibrin. Due to the lower dissolution of fibrin, the level of the protein in the blood increases. This reduces blood loss. Antifibrinolytics succeed in suppressing fibrinolysis pharmacologically.

Medicinal Application & Use for Treatment & Prevention

Antifibrinolytics can be used both for therapeutic purposes and preventively as part of prophylaxis. The purpose of the award is always to treat bleeding that occurs as a result of hyperfibrinolysis. Hyperfibrinolysis is present when the enzymatic cleavage of the body’s own protein fibrin (fibrinolysis) is pathogenically increased.

Some antifibrinolytics such as B. tranexamic acid are also suitable for use as an antidote . Antidotes are those substances that inactivate the effects of a toxic substance or at least reduce or mitigate their effects. However, the field of application as an antidote remains limited to the treatment of bleeding that occurs during fibrinolytic therapy.

Antifibrinolytics are also used in obstetrics . Here they are said to improve coagulation in postpartum bleeding. In addition, there is also an indication for dental interventions and surgical measures with an increased risk of bleeding (e.g. in operations on the prostate or the gastrointestinal tract ). In these cases, antifibrinolytics are administered as a prophylactic agent.

Other fields of application of antifibrinolytics are persistent nosebleeds , hereditary angioedema , fibrinogen administration and particularly pronounced menstrual bleeding ( hypermenorrhoea ).

Antifibrinolytics can be administered or taken both intravenously and orally (as effervescent or film-coated tablets). All representatives of this class of active ingredients are subject to pharmacy and prescription requirements.

Risks & side effects

Like other medically active substances, antifibrinolytics can lead to undesirable side effects after ingestion . First of all, it should be checked whether an allergy to antifibrinolytics is known. If this is the case, it is imperative that you do not take it because there is a contraindication. This describes that there is a medical contraindication that prohibits the treatment from a medical point of view.There is also a contraindication during breastfeeding , since antifibrinolytics can get into breast milk . Patients who suffer from thrombosis or are at increased risk of thrombosis should also not take any antifibrinolytics. During pregnancy , a comprehensive risk assessment must be carried out by the doctor.

Common side effects include skin reactions ( itching , rashes , redness ), atrial fibrillation , and visual disturbances . For patients who suffer from a risk of thrombosis, there is also the risk of a stroke , a heart attack or a pulmonary embolism .

Additionally, when antifibrinolytic drugs are used to treat urinary bleeding , clots can form, which can lead to additional hazards. A comprehensive risk/opportunity assessment must therefore be carried out before taking it, as a contraindication may exist.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.