Tranexamic Acid

PHARMACOLOGY

Inhibits the breakdown of fibrin clots. Tranexamic acid has been used PO, topically and IV. It accumulates in renal failure

Duration of action: 24 h
Plasma ½ life: 2 h

DOSING

  • 500-1000 mg tid PO/IV
  • Topical: solution 500 mg in 5 mls soaked in gauze – apply for 10 minutes
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  • 10-20 mg/kg/dose bid to tid IV
  • 25 mg/kg/dose tid to qid PO

UNWANTED EFFECTS

  • Nausea
  • Vomiting
  • Diarrhoea
  • Disturbance in colour vision
  • Hypotension (IV)
  • Thrombo-embolism

PITFALLS/CONCERNS

  • In patients with hematuria there is a risk of ureteric obstruction and retention
  • There exist serious drug interactions which can increase the risk of thrombosis

NOTE

This information is drawn from a number of sources (see below). The reader is encouraged to access these and other relevant literature for more detail. As always, sound clinical judgment should be used in individual clinical cases. In particular, it should be remembered that there may be significant variation in the pharmokinetics of a drug resulting from a number of factors, including the individual patient’s metabolism/disease status and how the medication has been formulated.

SOURCES/REFERENCES

  1. Brunton LL, Lazo JS, Parker KL, editors. Goodman and Gilman’s: the pharmacological basis of therapeutics. 11th ed. McGraw-Hill Professional; 2006.
  2. Twycross R, Wilcock A. Palliative care formulary. 3rd ed. Radcliffe Medical Press Ltd; 2008.
  3. Repchinsky C, editor. Compendium of pharmaceuticals and specialties (CPS): the Canadian drug reference for health professionals. 44th ed. Canadian Pharmacists Association; 2009.
  4. Goldman A, Hain R, Liben S. Oxford textbook of palliative care for children. 1st ed. Oxford University Press; 2006.

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