Pharm 101: Tranexamic Acid

Class

Fibrinolytic inhibitor

Pharmacodynamics
  • Tranexamic acid is an analog of aminocaproic acid, a synthetic inhibitor of fibrinolysis which competitively inhibits plasminogen activation
Pharmacokinetics
  • Rapid oral absorption
  • Minimal protein binding due to binding plasmin
  • Minimal metabolism
  • Renal excretion
Clinical uses
  • Epistaxis
  • Haemoptysis
  • Menorrhagia
  • Haemorrhagic shock (including trauma, surgical haemorrhage)
  • Reduced peri-operative bleeding
  • Reversal of thrombolytic therapy
  • Dosage is usually 1g PO/IV, q6-8h depending on exact indication
Adverse effects
  • Intravascular thrombosis due to inhibition of plasminogen activator
  • Myopathy
  • Hypotension (usually with rapid IV infusion)
  • GI upset when taken orally
Precautions/contraindications
  • Active intravascular clotting (DIC)
  • Upper renal tract bleeding due to possibility of clot retention
  • Dose reduction in renal failure
Further reading
Pharm 101 700

Pharmacology 101

Top 200 drugs

MBBS (UWA) CCPU (RCE, Biliary, DVT, E-FAST, AAA) Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Editor-in-chief of the LITFL ECG Library. Twitter: @rob_buttner

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