Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 100mg/mL
Dental Extraction in Patients with Hemophilia
Indicated in patients with hemophilia for short-term use (ie, 2-8 days) to reduce/prevent hemorrhage and reduce the need for replacement therapy during and following tooth extraction
10 mg/kg IV immediately before surgery OR 10 mg/kg IV q6-8hr 1 day before surgery
25 mg/kg PO q6-8hr 1 day presurgery AND 2-8 days postsurgery
CABG (Off-label)
10-15 mg/kg IV over 20 minutes, THEN 1 mg/kg/hr continuous infusion for 6-10 hours
Hereditary Angioedema (Off-label)
Long-term prophylaxis: 1000-1500 mg PO q8-12hr; reduce dose to 500 mg/dose PO qDay or q12hr when frequency of attacks reduces
Short term prophylaxis: 75 mg/kg/day PO divided q8-12hr for 5 days before and after the event
Treatment of acute HAE attack: 25 mg/kg/dose PO/IV; not to exceed 1000 mg/dose q3-4hr; not to exceed 75 mg/kg/day or 1000 mg PO q6hr for 48 hr
Total Knee Replacement Surgery, Blood Loss Reduction (Off-label)
10 mg/kg IV over 30 min before inflation of tourniquet and 3 hr after first dose
Hyphema (Off-label)
Renal Impairment
Dental Extraction
- SCr 1.36-2.83 mg/dL (120-250 micromoles/L): 10 mg/kg IV q12hr OR 15 mg/kg PO q12hr
- SCr 2.83-5.66 mg/dL (250-500 micromoles/L): 10 mg/kg IV qDay OR 15 mg/kg PO qDay
- SCr >5.66 mg/dL (>500 micromoles/L): 10 mg/kg IV q48hr OR 15 mg/kg PO q48hr; alternatively, 5 mg/kg IV qDay OR 7.5 mg/kg PO qDay
Dosage Forms & Strengths
injectable solution
- 100mg/mL
Dental Extraction in Patients with Hemophilia
10 mg/kg IV immediately before surgery OR 10 mg/kg IV q6-8hr 1 day before surgery
25 mg/kg PO q6-8hr 1 day presurgery AND 2-8 days postsurgery
Hyphema (Off-label)
25 mg/kg PO q8hr for 5-7 days
Hereditary Angioedema (Off-label)
Long term prophylaxis: 20-40 mg/kg/day PO divided q8-12hr; reduce dosing frequency to every other day or twice weekly when frequency of attacks reduces
Short term prophylaxis: 20-40 mg/kg/day PO divided q8-12hr; initiate 2-5 days before and continue for 2 days after the procedure
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- prothrombin complex concentrate, human
tranexamic acid injection increases effects of prothrombin complex concentrate, human by pharmacodynamic synergism. Contraindicated. Coadministration increases risk of thrombosis.
Serious - Use Alternative (3)
- anti-inhibitor coagulant complex
anti-inhibitor coagulant complex, tranexamic acid injection. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration ma.
tranexamic acid injection, anti-inhibitor coagulant complex. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration ma. - Factor IX
tranexamic acid injection increases effects of Factor IX by pharmacodynamic synergism. Contraindicated. Risk of thrombosis.
- Factor IX, recombinant
tranexamic acid injection increases effects of Factor IX, recombinant by pharmacodynamic synergism. Contraindicated. Risk of thrombosis.
Monitor Closely (2)
- defibrotide
tranexamic acid injection decreases effects of defibrotide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Defibrotide may diminish effects of thrombolytic agents. Consider therapy modification.
- mestranol
tranexamic acid injection, mestranol. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of thromboembolic disorder.
Minor (0)
Adverse Effects
Frequency Not Defined
Visual abnormalities
Hypotension (with rapid injection)
Nausea
Vomiting
Diarrhea
Anaphylaxis
Warnings
Contraindications
Hypersensitivity
Acquired defective color vision
Subarachnoid hemorrhage
Active intravascular clotting
Cautions
Use caution in renal impairment, subarachnoid hemorrhage, vascular disease, thromboembolic history, and DIC
Ureteral obstruction resulting from clot formation reported; use caution in patients with upper urinary tract bleeding
Thromboembolism or venous and arterial thrombosis reported
Ligneous conjunctivitis has been reported
Concurrent use with anti-inhibitor coagulant complex/factor IX complex concentrates may further increase risk of thrombosis
Concurrent use with tretinoin may exacerbate procoagulant effects
Anaphylaxis reported with intravenous administration
For intravenous use only; serious adverse reactions including seizures and cardiac arrythmias have occurred when drug inadvertently administered intrathecally instead of intravenously; confirm correct route of administration and avoid confusion with other injectable solutions that might be administered at same time as the drug; syringes containing drug should be clearly labeled with intravenous route of administration
Visual disturbances
- Visual defects (color vision change or visual loss) reported
- In addition, although not seen in humans, focal areas of retinal degeneration have been observed in cats and dogs following oral or intravenous tranexamic acid at doses between 250 to 1600 mg/kg/day (1.6 to 22 times recommended usual human dose based on body surface area) from 6 days to 1 year
- No retinal changes observed in eye examinations of patients treated with tranexamic acid for up to 8 years; patients expected to be treated for greater than 3 months may consider ophthalmic monitoring including visual acuity and optical coherence tomography at regular intervals; discontinue tranexamic acid in sodium chloride injection if changes in ophthalmological examination occur
Seizures
- May cause seizures, including focal and generalized seizures; the most common setting for tranexamic acid-induced seizures has been during cardiovascular surgery (a setting in which drug is not FDA approved and which uses doses of up to ten-fold higher than recommended human dose and in patients inadvertently given tranexamic acid into the neuraxial system)
- Consider dose reduction during surgery and dose adjustments for patients with clinical conditions such as renal dysfunction; closely monitor patient during surgery
- Consider electroencephalogram (EEG) monitoring for patients with history of seizures or who experience myoclonic movements, twitching, or show evidence of focal seizures; discontinue drug if seizures occur
Pregnancy & Lactation
Pregnancy
Available data from published studies, case series and case reports with tranexamic acid use in pregnant women in second and third trimester and at time of delivery have not clarified whether there is a drug-associated risk of miscarriage or adverse maternal or fetal outcomes
There are 2 (0.02%) infant cases with structural abnormalities that resulted in death when tranexamic acid was used during conception or first trimester of pregnancy; however, due to other confounding factors the risk of major birth defects with use of tranexamic acid during pregnancy is not clear
Drug is known to pass the placenta and appears in cord blood at concentrations approximately equal to maternal concentration
Animal data
- Reproduction studies performed in mice, rats, and rabbits have not revealed any adverse effects on fetus due to tranexamic acid administered during organogenesis; doses examined were multiples of up to 3 times (mouse), 6 times (rat), and 3 times (rabbit) maximum human dose based on body surface area in the mouse, rat, and rabbit, respectively
Contraception
- Concomitant use of drug, which is an antifibrinolytic, with hormonal contraceptives may increase risk for thromboembolic adverse reactions; advise patients to use an effective alternative (nonhormonal) contraceptive method
Lactation
Published literature reports presence of tranexamic acid in human milk; there are no data on effects of drug on breastfed child or effects on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for drug and any potential adverse effects on breastfed child from drug or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Inhibits fibrinolysis by displacing plasminogen from fibrin
Reduces plasmin activity, which in turn reduces activation of complement and consumption of C1 esterase inhibitor (C1-NH) and subsequently decreases inflammation associated with hereditary angioedema
Pharmacokinetics
Half-Life: 2-11 hr
Duration: 3 hr (after 1 dose)
Peak Plasma time: 3 hr
Plasma concentration: 15 mg/L
Protein Bound: 3%
Vd: 9-27 L
Clearance: 110-116 mL/min
Excretion: Urine (95%)
Administration
IV Incompatibilities
Additive: blood, penicillin
IV Compatibilities
Solution: compatible with most common solutions for infusion
Additive: heparin
IV Preparation
Prepare solution same day it will be used
Dilute a single dose w/t 50 mL compatible fluid (eg, NS, Ringers, dextrose/water)
IV Administration
100 mg or fraction thereof over at least 1 min, usually 5 minutes
Avoid rapid infusion
Storage
Store at 25°C (77°F)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| tranexamic acid oral - | 650 mg tablet |  | |
| tranexamic acid oral - | 650 mg tablet |  | |
| tranexamic acid oral - | 650 mg tablet |  | |
| tranexamic acid oral - | 650 mg tablet |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) solution |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| tranexamic acid intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| Cyklokapron intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| Cyklokapron intravenous - | 1,000 mg/10 mL (100 mg/mL) solution |  | |
| Cyklokapron intravenous - | 1,000 mg/10 mL (100 mg/mL) vial |  | |
| Cyklokapron intravenous - | 1,000 mg/10 mL (100 mg/mL) solution |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
tranexamic acid oral
TRANEXAMIC ACID 500 MILLIGRAM TABLET - ORAL
(TRAN-ex-AM-ik AS-id)
COMMON BRAND NAME(S): Cyklokapron
USES: This medication is used short-term in people with a certain type of bleeding disorder (hemophilia) to prevent and reduce bleeding from having a tooth pulled (extraction). It is also used in people with other high-risk bleeding conditions to control bleeding at such times as after surgery or an injury, during heavy nosebleeds, or during heavy menstrual bleeding.Tranexamic acid works by helping the blood clot normally to prevent and stop prolonged bleeding. It belongs to a class of drugs known as anti-fibrinolytics.
HOW TO USE: Take this medication by mouth as directed by your doctor, usually 2 to 4 times daily.The dosage and length of treatment is based on your medical condition and response to treatment. The dosage is also based on your weight. Do not increase your dose, take it more often, or take it for a longer time than prescribed.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Nausea, vomiting, diarrhea, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: eye/eyelid problems.Although unlikely, this medication may cause serious blood clot problems and vision changes. Get medical help right away if any of these very serious side effects occur: chest/jaw/left arm pain, sudden shortness of breath, coughing up blood, fainting, pain/swelling/warmth in the groin/calf, swelling/weakness/redness/pain in the arms/legs, confusion, trouble speaking, weakness on one side of the body, vision changes (such as color vision changes, loss of vision).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking tranexamic acid, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood clots (such as in the legs, lungs, brain, eye), bleeding in the brain (subarachnoid hemorrhage), color vision problems, a certain serious blood clotting problem (disseminated intravascular coagulation-DIC), kidney problems (including blood in the urine), irregular menstrual bleeding of unknown cause.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: "blood thinners" (anticoagulants such as warfarin, heparin), drugs that prevent bleeding (including factor IX complex, anti-inhibitor coagulant concentrates), estrogens, hormonal birth control (such as pills, patch, ring), tibolone.Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as aspirin, ibuprofen, naproxen) that may increase your risk of bleeding. Low-dose aspirin should be continued if prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually 81-162 milligrams a day). Ask your doctor or pharmacist for more details.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, vomiting.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as eye exams) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised August 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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