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Antifibrinolytics help stabilize an existing fibrin clot by inhibiting plasminogen activation or, in the case of aprotinin, directly inhibiting proteases involved in fibrinolysis. Tranexamic acid and ε-aminocaproic acid act as lysine analogues, competing for binding sites on plasminogen and plasmin. The lesson considers their clinical use to reduce bleeding across several settings, alongside adverse effects, contraindications, cautions, and monitoring considerations. It also clarifies that these drugs do not reverse anticoagulants and require fibrin to exert their effect. Desmopressin is distinguished as a pro-hemostatic agent rather than an antifibrinolytic. Together, these concepts provide a framework for understanding where antifibrinolytics fit within bleeding management.