Generic Name

Tranexamic Acid

Precaution

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.

Indication

Haemorrhage, Hereditary angioedema, Heavy Menstrual Bleeding (Menorrhagia), Tooth Extraction in Patients with Hemophilia, Refractory melasma

Contra Indication

Severe renal failure, active intravascular clotting, thromboembolic disease, colour vision disorders, subarachnoid bleeding.

Dose

N/A

Side Effect

>10% Headache (50.4%),Nasal and sinus symptoms (25.4%),Back pain (20.7%),Abdominal pain (19.8%),Musculoskeletal pain (11.2%) 1-10% Arthralgia (6.9%),Muscle cramps and spasms (5.8%),Migraine (6%),Anemia (5.6%),Fatigue (5.2%) Frequency Not Defined Visual abnormalities,Hypotension (with rapid injection),Nausea,Vomiting,Diarrhea

Pregnancy Category

Mode of Action

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.

Interaction

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.

Pregnancy Category Note

Pregnancy Category: B Lactation: Excreted in breast milk, not recommended

Adult Dose

Oral Short-term management of haemorrhage Adult: 1-1.5 g or 15-25 mg/kg bid or tid. Management of hereditary angioedema Adult: 1-1.5 g bid or tid. Menorrhagia Adult: 1 g tid during menstruation as necessary for up to 5 days, may be increased for heavy bleeding. Max: 4 g daily. Patients with haemophilia undergoing dental extraction Adult: 1.5 g (or 25 mg/kg) 8 hourly. 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 Dose

Oral Short-term management of haemorrhage Child: 25 mg/kg bid or tid. Management of hereditary angioedema Child: 25 mg/kg bid or tid. Intravenous Short-term management of haemorrhage Child: 10 mg/kg bid or tid.

Renal Dose

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.

Administration

May be taken with or without food.