Tranexamic acid

CLINICAL USE

Haemostatic agent

DOSE IN NORMAL RENAL FUNCTION

Oral: 1–1.5 g every 8–12 hours (15–25 mg/ kg every 8–12 hours) IV: 0.5–1 g every 8 hours (25–50 mg/kg daily in divided doses) Dose depends on indication

PHARMACOKINETICS

Molecular weight : 157.2

%Protein binding : 3

%Excreted unchanged in urine : 90

Volume of distribution (L/kg) : 1

half-life – normal/ESRD (hrs) : 2/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : IV: 10 mg/kg 12 hourly. Oral: 25 mg/ kg 12 hourly

10 to 20 : IV: 10 mg/kg 12–24 hourly. Oral: 25 mg/kg 12–24 hourly

<10 : IV: 5 mg/kg 12–24 hourly. Oral: 12.5 mg/kg 12–24 hourly

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Unknown dialysability. Dose as in GFR <10 mL/min

HD : Unknown dialysability. Dose as in GFR <10 mL/min

HDF/high flux : Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD : Unknown dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

–

Route

IV, oral

Rate of Administration

Slow bolus =100 mg/minute or continuous

IV infusion

in glucose 5% or sodium chloride 0.9%

Comments

–

OTHER INFORMATION

A 5% topical solution can be made up using the IV preparation, mixed with water for injection. This can be used as a mouthwash to stop bleeding after dental surgery, or placed on a swab to reduce bleeding at fistula or other bleeding sites if conventional measures have not worked (anecdotal) .

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