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 Emergency Medicine Trainee with interests in medical education, ECG interpretation, and the use of point-of-care ultrasound in the undifferentiated patient. Co-author of the LITFL ECG Library | Twitter

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