Last updated: September 2023
- 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
- 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.
- 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
- 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).