Tranexamic Acid

Indications & Dose:

Local fibrinolysis

• BY MOUTH

Adult: 1–1.5 g 2–3 times a day, alternatively 15–25 mg/kg 2–3 times a day

• INITIALLY BY SLOW INTRAVENOUS INJECTION

Adult: 0.5–1 g 2–3 times a day, to be administered at a rate not exceeding 100 mg/minute, dose may be followed by continuous infusion; (by continuous intravenous infusion) 25–50 mg/kg, dose to be given over 24 hours

Menorrhagia

• BY MOUTH

Adult: 1 g 3 times a day for up to 4 days, to be initiated when menstruation has started; maximum 4 g per day

Hereditary angioedema

• BY MOUTH

Adult: 1–1.5 g 2–3 times a day, for short-term prophylaxis of hereditary angioedema, tranexamic acid is started several days before planned procedures which may trigger an acute attack of hereditary angioedema (e.g.dental work) and continued for 2–5 days afterwards

Epistaxis

• BY MOUTH

Adult: 1 g 3 times a day for 7 days

General fibrinolysis

• BY SLOW INTRAVENOUS INJECTION

Adult: 1 g every 6–8 hours, alternatively 15 mg/kg every 6–8 hours, dose to be given at a rate not exceeding 100 mg/minute

Contraindications:

Active thromboembolic disease; history or intrinsic risk of thrombosis or thromboem-bolism, including retinal vein or artery occlusion; hypersensitivity to tranexamic acid or its components

Side Effects:

Vomiting, diarrhea, giddiness on rapid intravenous injection

Cautions:

Reduce dose in renal impairment; massive haematuria (avoid if risk of ureteric obstruction); regular eye examination and liver function tests in long-term treatment of hereditary angioedema. Note: Requirement for regular eye examination during long-term treatment is based on unsatisfactory evidence.

Precautions:

Interaction:

DRUGS

anti-inhibitor coagulant concentrates, factor IX complex concentrates, hormonal contraceptives: Increased thrombotic risk tissue plasminogen activators: Possibly decreased effectiveness of both tranexamic acid and the tissue plasminogen activator tretinoin (oral): Possibly exacerbation of the procoagulant effect of tretinoin

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Cerebral thrombosis, dizziness, fatigue, headache, migraine, seizures

CV: Deep vein thrombosis, MI

EENT: Central retinal artery and vein obstruction, feeling of tightness in throat, impaired color vision, ligneous conjunctivitis, nasal and sinus congestion, sinusitis, visual abnormalities

GI: Abdominal pain, diarrhea, nausea, Vomiting

Patient And Carer Advice: