TRANEXAMIC acid injectable

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    Last updated: September 2023

     

    Prescription under medical supervision

     

    Therapeutic action

    • Antifibrinolytic

    Indications

    • Postpartum haemorrhage
    • Heavy abnormal uterine bleeding unrelated to pregnancy
    • Trauma-associated haemorrhage

    Forms and strengths, route of administration

    • 500 mg in 5 ml ampoule (100 mg/ml) for slow IV injection or infusion in 0.9% sodium chloride or 5% glucose
    • DO NOT ADMINISTER BY IM ROUTE.

    Dosage and duration

    Postpartum haemorrhage

    • Adolescent under 15 years: 15 mg/kg (max. 1 g)
    • Adult: 1 g

    Administer the dose over 15 minutes, in the first litre used for fluid resuscitation or in a bag of 100 ml of 0.9% sodium chloride, within 3 hours of delivery.

    If haemorrhage persists 15 minutes after the end of first dose or restarts within 24 hours, administer a second dose in 100 ml of 0.9% sodium chloride over 15 minutes (max. total dose 2 g).

     

    Heavy abnormal uterine bleeding unrelated to pregnancy

    • Adolescent and adult: 10 mg/kg every 8 hours until bleeding is reduced (max. 600 mg/dose) then, change to oral route.

     

    Trauma-associated haemorrhage

    • Child: 15 mg/kg (max. 1 g)
    • Adult: 1 g 

    Administer the dose over 10 minutes, in 5 ml/kg of 0.9% sodium chloride in children less than 20 kg and in 100 ml of 0.9% sodium chloride in children 20 kg and over and adults, within 3 hours of injury. Then, administer a second dose by continuous IV infusion over 8 hours.

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with (or with history of) venous or arterial thromboembolic disorders, severe renal impairment, history of seizures. 
    • Reduce dosage in patients with mild to moderate renal impairment (risk of accumulation).
    • May cause: gastrointestinal disturbances, hypotension and malaise if injected rapidly (rate > 1 ml/minute), seizures with high doses, visual disturbances, allergic reactions.
    • Avoid combination with drugs that increase the risk of thromboembolism (e.g. oestrogenes).
    • Pregnancy: this drug is not indicated in the event of bleeding during pregnancy.
    • Breast-feeding: no contra-indication

    Remarks

    • Do not mix with benzylpenicillin (incompatibility).
    • Tranexamic acid can also be administered undiluted or diluted in smaller volumes of 0.9% sodium chloride (e.g. 10 ml) in case of fluid restriction (max. 100 mg/minute or 1 ml/minute).        

    Storage

     
    –  Below 25 °C