Diferencia entre revisiones de «Tranexamic acid»
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Revisión actual - 21:56 20 mar 2026
Background
- Action: Antifibrinolytic agent
- Competitive inhibitor of plasminogen activation to plasmin
- Dosing Availability:
- Ampule of 1 Gm in 10 mL
- Formulations: IV and PO; can use IV as topical
- Common Trade Names: Cyklokapron
Indication
FDA-approved only for:
- Postpartum bleeding
- Periprocedural hemorrhage in hemophiliacs.
More common off-label uses:
- Severely bleeding trauma patient, systolic blood pressure of <90 and/or heart rate > 110 beats/min, or with expected requirement for massive transfusion
- Epistaxis, especially in anticoagulated patients
- Under investigation for use in intracranial hemorrhage and GI bleeding
Contraindication/Exclusion Criteria
- Greater than 3 hours from injury
- Known sensitivity to TXA
- Previous DVT or Pulmonary Embolism
Administration
Adult dose
Total of 2 Grams
- Initial bolus of 1 Gm over 10 minutes (Slow IV push). Draw up with filter needle.
- Maintenance: additional 1 Gm over next 8 hours (mix in 50 mL of NS). Call Pharmacy to mix and deliver the continuous infusion.[1]
Pediatric dose
Weight based
- Initial bolus of 20mg/kg IV Bolus over 10 minutes
- Maintenance: 10 mL/kg/hr over next 8 hours
No additional laboratory tests required.
Topical use
- Epistaxis: 500mg-1g IV applied to packing or pressure device, some practitioners mix 1:1 with NS in a basin
Adverse Reactions
- Thrombotic events
- Hypotensionwith rapid injection
- Nausea, vomiting, diarrhea
- Impaired color vision and other visual disturbances
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Angioedema | 1 g IV over 10 min | Bradykinin-mediated angioedema (e.g., ACE-I induced) | IV | Adult |
| Epistaxis | 500mg topically | Applied to foam or packing and inserted into nares | Topical (intranasal) | Adult |
| Intracranial hemorrhage (main) | 1g IV (within 3 hrs of event), then 1g over 8 hrs | Coagulopathy reversal in ICH | IV | Adult |
| Postpartum hemorrhage | 1 g over 10 min, repeat in 30 min if ongoing bleed | Antifibrinolytic | IV | Adult |
| Traumatic intracerebral hemorrhage | 1g IV (within 3 hrs of event), then 1g over 8 hrs | Coagulopathy reversal in ICH | IV | Adult |
See Also
- MATTERs Study
- Crash-2 Trial
- Crash-3 Trial
- Halt it trial
- WOMAN trial - https://rebelem.com/the-woman-trial-early-txa-in-post-partum-hemorrhage/
- Transfusions
- Transfusion Reactions
External Links
References
- ↑ CRASH-2 collaborators, Roberts I, Shakur H, Afolabi A, Brohi K, Coats T, Dewan Y, Gando S, Guyatt G, Hunt BJ, Morales C, Perel P, Prieto-Merino D, Woolley T. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet. 2011 Mar 26;377(9771):1096-101,