Tranexamic Acid

Indications
 Oral
Short-term management of haemorrhage
Adult: 1-1.5 g or 15-25 mg/kg 2-4 times daily.
Child: 25 mg/kg bid or tid.
Renal impairment: Adjust dose based on serum creatinine concentration: 120-250 micromol/l: 15 mg/kg bid daily; 250-500 micromol/l: 15 mg/kg once daily; >500 micromol/l: 7.5 mg/kg once daily or 15 mg/kg once every 48 hr.
Oral
Management of hereditary angioedema
Adult: 1-1.5 g bid or tid.
Child: 25 mg/kg bid or tid.
Renal impairment: Adjust dose based on serum creatinine concentration: 120-250 micromol/l: 15 mg/kg bid daily; 250-500 micromol/l: 15 mg/kg once daily; >500 micromol/l: 7.5 mg/kg once daily or 15 mg/kg once every 48 hr.
Intravenous
Short-term management of haemorrhage
Adult: 0.5-1 g or 10 mg/kg tid or 25-50 mg/kg daily by continuous infusion.
Child: 10 mg/kg bid or tid.
Renal impairment: Adjust dose based on the serum-creatinine concentration: 120-250 micromol/l: 10 mg/kg bid daily; 250-500 micromoles/l: 10 mg/kg once daily; >500 micromol/l: 5 mg/kg once daily or 10 mg/kg once every 48 hr.

Special Populations: Renal impairment: Short-term management of haemorrhage: CrCl: >500 micromol/L: 12.5 mg/kg body wt once daily oral dose or 5 mg/kg IV once daily; 250-500 micromol/L: 25 mg/kg body wt bid oral dose or 10 mg IV once daily; 120-250 micromol/L: 25 mg/kg bid oral dose or 10 mg/kg body wt IV bid.

Incompatibility: Incompatible with benzylpenicillin.
Contraindications
 Severe renal failure, active intravascular clotting, thromboembolic disease, colour vision disorders, subarachnoid bleeding.
Warnings / Precautions
 Mild to moderate renal impairment, irregular menstrual bleeding, previous history of thromboembolic disease, haematuria. Monitor closely in disseminated intravascular coagulation. Monitor LFT and eye examination regularly during long-term use. Discontinue if disturbance in colour vision occurs. Avoid IV inj rate >1 ml/minute due to risk of hypotension. Pregnancy, lactation.
Adverse Reactions
 Diarrhoea, nausea, vomiting, disturbances in colour vision, giddiness, hypotension (after rapid IV inj), thromboembolic events.
Overdose Reactions
 Symptoms: Nausea, vomiting, orthostatic symptoms and/or hypotension.
Drug Interactions
 Potentially Fatal: Increased risk of thrombus formation with estrogens, Factor IX complex concentrates or anti-inhibitor coagulant concentrates. Increased risk of fatal thrombotic complications with tretinoin in acute promyelocytic leukaemia.
See Below for More tranexamic acid Drug Interactions
Mechanism of Actions
 Tranexamic acid is an antifibrinolytic agent that competitively inhibits breakdown of fibrin clots. It blocks binding of plasminogen and plasmin to fibrin, thereby preventing haemostatic plug dissolution.
Absorption: Absorbed from the GI tract; peak plasma concentrations after 3 hr (oral). Bioavailability: 30-50%, unaffected by food intake.
Distribution: Widely throughout the body. Protein-binding: Very low. Crosses the placenta and distributed into breast milk.
Excretion: Urine (as unchanged drug); 2 hr (elimination half-life).
Administration
 May be taken with or without food.
Storage Conditions
 Intravenous: Store at 15-30°C (59-86°F). Oral: Store at 15-30°C (59-86°F).
ATC Classification
 B02AA02 - tranexamic acid ; Belongs to the class of amino acid antifibrinolytics. Used in the treatment of hemorrhage.
Storage
 Intravenous: Store at 15-30°C (59-86°F). Oral: Store at 15-30°C (59-86°F).
Available As
  • Tranexamic Acid 100 mg
  • Tranexamic Acid 1000 mg
  • Tranexamic Acid 250 mg
  • Tranexamic Acid 500 mg

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