TRANEXAMIC ACID Tranexamic acid containing medicinal products Ref.[7892] Active ingredients: Tranexamic acid

Source: European Medicines Agency (EU)  Revision Year: 2019 

Therapeutic indications

Prevention and treatment of haemorrhages due to general or local fibrinolysis in adults and children from one year.

Specific indications include:

  • Haemorrhage caused by general or local fibrinolysis such as:
    • Menorrhagia and metrorrhagia,
    • Gastrointestinal bleeding,
    • Haemorrhagic urinary disorders, further to prostate surgery or surgical procedures affecting the urinary tract,
  • Ear Nose Throat surgery (adenoidectomy, tonsillectomy, dental extractions),
  • Gynaecological surgery or disorders of obstetric origin,
  • Thoracic and abdominal surgery and other major surgical intervention such as cardiovascular surgery,
  • Management of haemorrhage due to the administration of a fibrinolytic agent.

Posology and method of administration

Posology

Adults

Unless otherwise prescribed, the following doses are recommended:

  1. Standard treatment of local fibrinolysis: 0.5 g (1 ampule of 5 ml) to 1 g (1 ampule of 10 ml or 2 ampules of 5 ml) tranexamic acid by slow intravenous injection (= 1 ml/minute) two to three times daily
  2. Standard treatment of general fibrinolysis: 1 g (1 ampule of 10 ml or 2 ampules of 5 ml) tranexamic acid by slow intravenous injection (= 1 ml/minute) every 6 to 8 hours, equivalent to 15 mg/kg BW

Renal impairment

In renal insufficiency leading to a risk of accumulation, the use of tranexamic acid is contraindicated in patient with severe renal impairment (see section 4.3). For patient with mild to moderate renal impairment, the dosage of tranexamic acid should be reduced according to the serum creatinine level:

Serum creatinine μmol/lSerum creatininemg/10 mlDose IVAdministration
120 to 2491.35 to 2.8210 mg/kg BWEvery 12 hours
250 to 5002.82 to 5.6510 mg/kg BWEvery 24 hours
>500>5.655 mg/kg BWEvery 24 hours

Hepatic impairment

No dose adjustment is required in patient with hepatic impairment.

Paediatric Population

In children from 1 year, for current approved indications as described in section 4.1, the dosage is in the region of 20 mg/kg/day. However, data on efficacy, posology and safety for these indications are limited.

The efficacy, posology and safety of tranexamic acid in children undergoing cardiac surgery have not been fully established. Currently available data are limited and are described in section 5.1.

Elderly

No reduction in dosage is necessary unless there is evidence of renal failure.

Method of administration

The administration is strictly limited to slow intravenous injection.

Overdose

No case of overdose has been reported.

Signs and symptoms may include dizziness, headache, hypotension, and convulsions. It has been shown that convulsions tend to occur at higher frequency with increasing dose.

Management of overdose should be supportive.

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