From the Guidelines
Taking aminocaproic acid with oral combined contraceptive pills is not recommended due to the increased risk of thrombosis associated with estrogen-containing contraceptives, as highlighted in the 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases 1.
Key Considerations
- The risk of venous thromboembolism (VTE) in healthy women taking combined estrogen-progestin contraceptives is significantly higher than the baseline annual risk, with odds ratios ranging from 2.2 to 6.6 1.
- Aminocaproic acid, an antifibrinolytic agent, can potentially increase the risk of thrombosis by inhibiting the breakdown of blood clots.
- The combination of these two medications may further increase the risk of thrombosis, particularly in individuals with a history of blood clots, thromboembolism, or clotting disorders.
- Alternative contraceptive options, such as progestin-only pills or intrauterine devices (IUDs), may be recommended for individuals who require antifibrinolytic therapy with aminocaproic acid.
Recommendations
- Individuals taking aminocaproic acid should discuss alternative contraceptive options with their healthcare provider to minimize the risk of thrombosis.
- Progestin-only pills or IUDs, which have a lower risk of thrombosis compared to combined estrogen-progestin contraceptives, may be considered as alternative options 1.
- Healthcare providers should carefully evaluate the individual's medical history and monitor them closely for signs of thrombosis when prescribing aminocaproic acid and contraceptive medications.
From the Research
Safety of Aminocaproic Acid with Oral Combined Contraceptive Pills
- There is limited direct evidence on the safety of taking aminocaproic acid with oral combined contraceptive pills 2, 3, 4, 5, 6.
- A study from 1975 found that aminocaproic acid reduced menstrual loss in women using intrauterine devices, but it did not investigate its use with oral combined contraceptive pills 4.
- Another study from 2021 discussed the effectiveness and adverse effects of various contraceptive methods, including oral combined contraceptive pills, but did not mention aminocaproic acid 3.
- A 2023 study compared the cardiometabolic effects of cabergoline and combined oral contraceptive pills in young women with hyperprolactinemia, but did not investigate the use of aminocaproic acid with oral combined contraceptive pills 5.
- A 2007 review of combined oral contraceptives discussed their benefits and risks, but did not mention aminocaproic acid 6.
- A 2003 study on tranexamic acid suggested that comparative studies with epsilon-aminocaproic acid, danazol, and combined oral contraceptives would be helpful to further define the place of the drug in the treatment of menorrhagia, but did not provide direct evidence on the safety of taking aminocaproic acid with oral combined contraceptive pills 2.