The oral dose is 1–1.5 g (15–25 mg/kg) 2–3 times per day. I.V. dosage is typically 0.5–1 g by slow injection three times per day. Alternatively, the initial dose can be followed by an infusion of 25 – 50 mg/kg over 24 h.
Dosing should be reduced to 5–10 mg kg IV in patients with renal failure.
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(10)60939-7.pdf - Dr Jerrold Levy (@JerroldLevy)
TXA is used to treat or prevent excessive blood loss from trauma, surgery, and in various conditions including hAemophilia and heavy menstrual bleeding.
Dr. David Lyness
Synth. derivative of the AA, lysine and binds the 5 lysine binding sites on plasminogen.
This inhibits plasmin formation and displaces plasminogen from the fibrin surface.
- No evidence for UGI bleeds
- Is used extensively in orthopaedic operations
- Reversal of drug-induced bleeding, like with dabigatran, rivaroxaban and LMWH's
- May improve platelet function and sometimes used post-cardiac surgery with such induced blood loss
- Oral surgery, by inhibiting fibrinolytic enzymes in saliva. MW or IV.
- ObGy - menorrhagia & new study is looking at PPH uses.
- Is used in cardiac surgery for blood loss
- Urology uses for haematuria, but can result in urinary clot retention
- Current studies looking into haemoptysis use - due to tPA action seen at pulmonary endothelium
- Liver/ENT/Max-Fax are currently awaiting cochrane review pubs.
- CRASH-2 & MATTERs trials show use in trauma patients - improving survival - it is hard to know how to translate findings --> surgery
Tranexamic acid may act as a competitive inhibitor of the central nervous system neurotransmitter GABA and it may also cause cerebral vasoconstriction and ischaemia.
Inhibits plasmin formation & displaces plasminogen, therefore preventing clot lysis.
Caution in those with renal failure
Antifibrinolytic drug.Simplistically considered the opposite of tPA (alteplase)