TRANEXAMIC acid injectable

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    Last updated: October 2021

     

    Prescription under medical supervision

     

    Therapeutic action

    • Antifibrinolytic

    Indications

    • Postpartum haemorrhage
    • Heavy abnormal uterine bleeding unrelated to pregnancy

    Presentation and 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 (two 5 ml ampoules) in a bag of 100 ml of 0.9% sodium chloride to be administered over 15 minutes within 3 hours of delivery. Repeat after 30 minutes if bleeding continues or within 24 hours of the first dose if bleeding restarts (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.

    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

    • Tranexamic acid is also used in the management of trauma patients with significant haemorrhage, at the same dosage, by slow IV injection or infusion, to be administered within 3 hours of injury, followed by 1 g over 8 hours by continuous infusion. Tranexamic acid is not indicated 3 hours after injury as its administration increases the risk of death.
    • Do not mix with benzylpenicillin (incompatibility).

    Storage

     
    – Below 25 °C