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://ceaccp.oxfordjournals.org/content/early/2014/05/30/bjaceaccp.mku009.full.pdf+html

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.

@Gas_Craic

Dr. David Lyness

propofology.com

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.