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.
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.
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.
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).
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.