Tranexamic acid


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Short-term management of haemorrhage Localised haemorrhage: 1-1.5 g bid or tid. Menorrhagia 1 g tid during menstruation as necessary for up to 5 days. Max: 4 g/day. Hereditary angioedema 1-1.5 g bid or tid intermittently or continuously. Patients with haemophilia undergoing dental extraction 1.5 g 8 hourly. IV Short-term management of haemorrhage Local: 0.5-1 g bid or tid. General: 1 g 6-8 hourly.
Dosage Details
Intravenous
Short-term management of haemorrhage
Adult: Local: 0.5-1 g bid or tid. General: 1 g (or 15 mg/kg) 6-8 hourly. Doses are administered by slow inj at a rate of 1 mL/min.

Oral
Menorrhagia
Adult: 1 g tid during menstruation as necessary for up to 5 days, may be increased for heavy bleeding. Max: 4 g daily.

Oral
Hereditary angioedema
Adult: 1-1.5 g bid or tid given intermittently or continuously, depending on patient condition.

Oral
Short-term management of haemorrhage
Adult: Localised: 1-1.5 g (or 15-25 mg/kg) bid or tid.

Oral
Patients with haemophilia undergoing dental extraction
Adult: 1.5 g (or 25 mg/kg) 8 hourly.
Renal Impairment
Oral:
Mild to moderate: Serum creatinine level (µmol/L): 120-249: 15 mg/kg bid. 250-500: 15 mg/kg daily. Severe: Contraindicated.
Intravenous:
Mild to moderate: Serum creatinine level (µmol/L): 120-249: 10 mg/kg 12 hourly. 250-500: 10 mg kg 24 hourly. >500: 5 mg/kg 24 hourly. Severe: Contraindicated.
Administration
May be taken with or without food.
Incompatibility
Intravenous:
Incompatible with benzylpenicillin.
Contraindications
Hypersensitivity. Active thromboembolic disease (e.g. pulmonary embolism, DVT), history of venous or arterial thrombosis (including retinal vein or artery occlusion), disseminated intravascular coagulation, fibrinolytic conditions after consumption coagulopathy, history of convulsions. Concomitant use with hormonal contraceptives. Severe renal impairment.
Special Precautions
Patients with enormous haematuria from upper urinary tract, history of thromboembolic diseases. Women with subarachnoid haemorrhage or irregular menstrual cycle. Mild to moderate renal impairment. Pregnancy and lactation.
Adverse Reactions
Significant: Visual and ocular disturbance (e.g. impaired colour vision), retinal vein or artery occlusion, ligneous conjunctivitis, thromboembolic events, convulsions.
Blood and lymphatic system disorders: Anaemia.
Gastrointestinal disorders: Diarrhoea, nausea, vomiting, abdominal pain.
General disorders and administration site conditions: Fatigue.
Musculoskeletal and connective tissue disorders: Musculoskeletal pain, muscle cramps.
Nervous system disorders: Headache, migraine.
Respiratory, thoracic and mediastinal disorders: Nasal and sinus symptoms.
Potentially Fatal: Severe hypersensitivity reactions including anaphylaxis.
IV/Parenteral/PO: B
Patient Counseling Information
This drug may cause dizziness, if affected, do not drive or operate machinery.
MonitoringParameters
Perform eye examinations at baseline then regularly during treatment.
Overdosage
Symptoms: Convulsions, dizziness, headache, hypotension, nausea, vomiting. Management: Supportive treatment.
Drug Interactions
Antagonistic effects with thrombolytics (e.g. alteplase, reteplase). Increased risk of thrombosis with factor IX complex concentrates or anti-inhibitor coagulant concentrates. May enhance the procoagulant effect of all-trans retinoic acid (oral tretinoin) in women with acute promyelocytic leukaemia.
Potentially Fatal: Concomitant use with hormonal contraceptives may increase the risk of venous thromboembolism or arterial thrombosis (e.g. MI, stroke).
Action
Description: Tranexamic acid inhibits fibrinolysis by blocking the binding of plasminogen and plasmin to fibrin, thus preventing dissolution of the haemostatic plug.
Pharmacokinetics:
Absorption: Absorbed from the gastrointestinal tract. Bioavailability: Approx 45% (oral). Time to peak plasma concentration: 2.5 hours after oral administration (range: 1-5 hours).
Distribution: Widely distributed throughout the body. It crosses the placenta and enters breast milk. Volume of distribution: 9-12 L. Plasma protein-binding: Approx 3%, mainly to plasminogen.
Excretion: Via urine (>95%, as unchanged drug). Elimination half-life: Approx 2-11 hours.
Chemical Structure

Chemical Structure Image
Tranexamic acid

Source: National Center for Biotechnology Information. PubChem Database. Tranexamic acid, CID=5526, https://pubchem.ncbi.nlm.nih.gov/compound/Tranexamic-acid (accessed on Jan. 23, 2020)

Storage
Store at 25°C.
MIMS Class
ATC Classification
B02AA02 - tranexamic acid ; Belongs to the class of amino acid antifibrinolytics. Used in the treatment of hemorrhage.
References
Anon. Tranexamic Acid. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 24/01/2019.

Buckingham R (ed). Tranexamic Acid. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 24/01/2019.

Tranexamic Acid Injection (Micro Labs Limited). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 24/01/2019.

Tranexamic Acid Tablet (Apotex Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 24/01/2019.

Disclaimer: This information is independently developed by MIMS based on Tranexamic acid from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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