tranexamic acid injection (Rx)

Brand and Other Names:Cyklokapron
  • Print

Dosing & Uses

AdultPediatric

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)

25 mg/kg PO q8hr for 5-7 days  

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

Next:

Interactions

Interaction Checker

and tranexamic acid injection

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            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)

              Previous
              Next:

              Adverse Effects

              Frequency Not Defined

              Visual abnormalities

              Hypotension (with rapid injection)

              Nausea

              Vomiting

              Diarrhea

              Anaphylaxis

              Previous
              Next:

              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
              Previous
              Next:

              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.

              Previous
              Next:

              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%)

              Previous
              Next:

              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)

              Previous
              Next:

              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              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) 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
              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) solution
              Cyklokapron intravenous
              -
              1,000 mg/10 mL (100 mg/mL) vial
              Cyklokapron intravenous
              -
              1,000 mg/10 mL (100 mg/mL) solution
              Lysteda oral
              -
              650 mg tablet
              tranexamic acid oral
              -
              650 mg tablet
              tranexamic acid oral
              -
              650 mg tablet
              tranexamic acid oral
              -
              650 mg tablet

              Copyright © 2010 First DataBank, Inc.

              Previous
              Next:

              Patient Handout

              Select a drug:
              Patient Education
              tranexamic acid intravenous

              NO MONOGRAPH AVAILABLE AT THIS TIME

              USES: Consult your pharmacist.

              HOW TO USE: Consult your pharmacist.

              SIDE EFFECTS: Consult your 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: Consult your pharmacist.

              DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

              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.

              NOTES: No monograph available at this time.

              MISSED DOSE: Consult your pharmacist.

              STORAGE: Consult your pharmacist.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 for more details about how to safely discard your product.

              Information last revised July 2016. Copyright(c) 2021 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.

              Previous
              Next:

              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
              Additional Offers
              Email to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Email Forms to Patient

              From:

              To:

              The recipient will receive more details and instructions to access this offer.

              By clicking send, you acknowledge that you have permission to email the recipient with this information.

              Previous
              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.