Provider Briefing: Aminocaproic Acid Supply in 2026

Aminocaproic Acid (epsilon-aminocaproic acid, EACA; brand name Amicar) — a cornerstone antifibrinolytic used across cardiothoracic surgery, hematology, and emergency medicine — continues to face supply constraints entering 2026. This article provides a clinical overview of the current shortage landscape, its implications for prescribing, and actionable resources to help your patients maintain access to therapy.

Shortage Timeline and Background

The supply challenges with Aminocaproic Acid are not new, but they have intensified over the past several years due to a convergence of factors:

• 2018-2020: Pfizer reported manufacturing delays for the injectable formulation (250 mg/mL, 20 mL vials), which was tracked on the ASHP Drug Shortage database.
• 2020-2023: Akorn, a manufacturer of the 1000 mg oral tablet, discontinued the product (NDC 61748-0046-01). This reduced the number of available suppliers for the higher-strength oral formulation.
• 2023-present: Intermittent availability across all oral and parenteral formulations. Supply from remaining generic manufacturers has not consistently met demand, particularly for the injectable form used in operative settings.

As of early 2026, the injectable formulation remains the most significantly affected. Oral tablets (500 mg) and oral solution (250 mg/mL) are generally available through wholesalers but may not be stocked at all retail pharmacies.

Prescribing Implications

The supply disruptions have several practical implications for prescribers:

Formulation Flexibility

If a patient reports difficulty obtaining the 1000 mg tablet, consider prescribing the 500 mg tablet with adjusted quantity (two tablets per dose). The oral solution is another option for patients who can't find tablets at all. When writing prescriptions, consider noting "or therapeutically equivalent formulation" to give pharmacists dispensing flexibility.

Therapeutic Substitution Considerations

When Aminocaproic Acid is unavailable, Tranexamic Acid is the most pharmacologically similar alternative:

• Both are lysine-analog antifibrinolytics with the same mechanism of action
• Tranexamic Acid is approximately 10x more potent — dosing adjustments are critical
• Tranexamic Acid is more widely available at retail pharmacies and generally easier for patients to obtain
• FDA-approved indications differ somewhat: Tranexamic Acid (Lysteda) carries an indication for heavy menstrual bleeding; Cyklokapron for hemophilia-related dental bleeding

For patients with mild hemophilia A or von Willebrand disease, Desmopressin (DDAVP) may be appropriate depending on the clinical scenario.

Dosing Reference

For providers unfamiliar with the conversion, approximate equivalency:

• Aminocaproic Acid: Loading dose 4-5 g, then 1-1.25 g/hour (max 30 g/24 hours)
• Tranexamic Acid: 1-1.3 g PO TID, or 10 mg/kg IV q6-8h (varies by indication)

These are not directly interchangeable doses — individualize based on indication, patient weight, and renal function. Tranexamic Acid also requires renal dose adjustment.

Current Availability Picture

A summary of formulation-level availability as of early 2026:

• 500 mg oral tablets: Available from generic manufacturers. Stocking varies by pharmacy. Independent and specialty pharmacies are more reliable sources.
• 1000 mg oral tablets: Limited. Akorn discontinued; availability depends on remaining generic suppliers.
• 250 mg/mL oral solution: Available but less commonly stocked at retail pharmacies.
• 250 mg/mL IV injection (20 mL vials): Most affected by shortage. Check institutional supply chain status and consider Tranexamic Acid IV as an alternative for surgical prophylaxis.

Cost and Access Considerations

Cost can be an additional barrier for patients, particularly those without insurance or with high-deductible plans:

• Average retail price: $290-$650 for oral tablets (varies by quantity)
• With discount cards (GoodRx, SingleCare): $32-$45
• IV formulation: ~$124+ for 500 mL

There is no active manufacturer savings program for Aminocaproic Acid since it is dispensed generically. Patient assistance programs through NeedyMeds, RxAssist, and RxHope may help patients with financial hardship. For patients struggling with cost, a detailed guide is available at how to help patients save money on Aminocaproic Acid.

Tools and Resources for Your Practice

Several tools can help you and your patients navigate availability challenges:

Medfinder for Providers

Medfinder offers a real-time pharmacy availability search that you or your staff can use to identify pharmacies with Aminocaproic Acid in stock before writing a prescription. This can reduce the cycle of patients bouncing between pharmacies and calling back for new prescriptions.

ASHP Drug Shortage Database

The ASHP Drug Shortage database provides updated manufacturer-level supply status and expected resolution dates when available. Checking this periodically can help you anticipate availability changes.

Proactive Prescribing Strategies

• When prescribing, consider 90-day supplies where appropriate to reduce refill frequency and pharmacy encounters
• Document the clinical necessity for Aminocaproic Acid specifically if insurance prior authorization is needed
• Provide patients with written guidance on using Medfinder or calling independent pharmacies
• Consider writing prescriptions for both Aminocaproic Acid and a backup alternative (e.g., Tranexamic Acid) with a note to fill the backup only if the primary is unavailable

Looking Ahead

There is no confirmed timeline for full resolution of the Aminocaproic Acid supply constraints. The fundamental issue — limited manufacturers for a niche generic product — is structural rather than temporary. Providers should:

• Maintain familiarity with Tranexamic Acid as an alternative
• Educate patients about proactive refill strategies
• Use availability tools like Medfinder to streamline the prescription-to-fill process
• Monitor ASHP shortage updates for changes in supply status

Final Thoughts

The Aminocaproic Acid shortage is a manageable but persistent challenge. With awareness of the supply landscape, familiarity with therapeutic alternatives, and use of real-time availability tools, providers can help patients maintain continuity of care.

For a patient-facing version of this information that you can share with your patients, see Aminocaproic Acid shortage update: what patients need to know. For guidance on helping patients locate the medication, see how to help your patients find Aminocaproic Acid in stock.