TRANEXAMIC acid injectable

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 -