Daily Medication Pearl: Tranexamic Acid

Medication Pearl of the Day: Tranexamic Acid

Indication: Tranexamic acid in sodium chloride injection is an antifibrinolytic indicated in patients with hemophilia for short-term use (2 to 8 days) to reduce or prevent hemorrhage and decrease the need for replacement therapy during and following tooth extraction.

Insight:

• Dosing: Before extraction administer 10 mg/kg actual body weight of tranexamic acid in sodium chloride injection intravenously (IV) with replacement therapy. After extraction administer 10 mg/kg actual body weight 3-4 times daily for 2 to 8 days. Infuse no more than 10 mL/minute to avoid hypotension.
• Dosage forms: Injection 1000 mg of tranexamic acid in 100 mL (10 mg/mL) sterile, unpreserved, colorless solution in a single-dose bag for IV use.
• Adverse events: Most common adverse reactions are nausea, vomiting, diarrhea, allergic dermatitis, giddiness, hypotension, and thromboembolic events.
• Mechanism of action: Tranexamic acid is a synthetic lysine amino acid derivative, which diminishes the dissolution of hemostatic fibrin by plasmin. In the presence of tranexamic acid, the lysine receptor binding sites of plasmin for fibrin are occupied, preventing binding to fibrin monomers, thus preserving and stabilizing fibrin’s matrix structure.

Source: Microsoft Word - NDA 212020 Action.docx (fda.gov)