Tranexamic Acid

Brand name: Hemostan, Fibrinon, Cyklokapron, Lysteda, Transamin

Classification: Anti-fibrinolytic, antihemorrhagic
Indications:
Tranexamic acid is used for the prompt and effective control of hemorrhage in va
rious surgical and clinical areas:
* Treating heavy menstrual bleeding
* Hemorrhage following dental and/or oral surgery in patients with hemophili
a
* Management of hemophilic patients (those having Factor VIII or Factor IX d
eficiency) who have oral mucosal bleeding, or are undergoing tooth extraction or
other oral surgical procedures.
* Surgical: General surgical cases but most especially operative procedures
on the prostate, uterus, thyroid, lungs, heart, ovaries, adrenals, kidneys, brai
n, tonsils, lymph nodes and soft tissues.
* Obstetrical and gynecological: abortion, post-partum hemorrhage and menome
trorrahgia
* Medical: epistaxis, hemoptysis, hematuria, peptic ulcer with hemorrhage an
d blood dyscrasias with hemorrhage
* Effective in promoting hemostasis in traumatic injuries.
* Preventing hemorrhage after orthopedic surgeries.
Mechanism of Action
Tranexamic acid is a synthetic derivative of the amino acid lysine. It exerts it
s antifibrinolytic effect through the reversible blockade of lysine-binding site
s on plasminogen molecules. Anti-fibrinolytic drug inhibits endometrial plasmino
gen activator and thus prevents fibrinolysis and the breakdown of blood clots. T
he plasminogen-plasmin enzyme system is known to cause coagulation defects throu
gh lytic activity on fibrinogen, fibrin and other clotting factors. By inhibitin
g the action of plasmin (finronolysin) the anti-fibrinolytic agents reduce exces
sive breakdown of fibrin and effect physiological hemostasis.
Contraindications
1. Allergic reaction to the drug or hypersensitivity
2. Presence of blood clots (eg, in the leg, lung, eye, brain), have a history
of blood clots, or are at risk for blood clots
3. Current administration of factor IX complex concentrates or anti-inhibitor
coagulant concentrates
Precautions
1. Pregnancy. Tranexamic acid crosses the placenta.
2. Lactation. Tranexamic acid is distributed into breast milk; concentrations
reach approximately 1% of the maternal plasma concentration.
3. Contraceptives, estrogen-containing, oral or Estrogens. Concurrent use wit
h tranexamic acid may increase the potential for thrombus formation.
4. Renal function impairment (medication may accumulate; dosage adjustment
based on the degree of impairment is recommended)
5. Hematuria of upper urinary tract origin (risk of intrarenal obstruction
secondary to clot retention in the renal pelvis and ureters if hematuria is mas
sive; also, if hematuria is associated with a disease of the renal parenchyma, i
ntravascular precipitation of fibrin may occur and exacerbate the disease)
Nursing Responsibilities
 1. Unusual change in bleeding pattern should be immediately reported to the p
hysician.
2. For women who are taking Tranexamic acid to control heavy bleeding, the me
dication should only be taken during the menstrual period.
3. Tranexamic Acid should be used with extreme caution in CHILDREN younger th
an 18 years old; safety and effectiveness in these children have not been confir
med.
4. The medication can be taken with or without meals.
5. Swallow Tranexamic Acid whole with plenty of liquids. Do not break, crush,
or chew before swallowing.
6. If you miss a dose of Tranexamic Acid, take it when you remember, then tak
e your next dose at least 6 hours later. Do not take 2 doses at once.
7. Inform the client that he/she should inform the physician immediately if t
he following severe side effects occur:
* Severe allergic reactions such as rash, hives, itching, dyspnea, tightness
in the chest, swelling of the mouth, face, lips or tongue
* Calf pain, swelling or tenderness
* Chest pain
* Confusion
* Coughing up blood
* Decreased urination
* Severe or persistent headache
* Severe or persistent body malaise
* Shortness of breath
* Slurred speech
* Slurred speech
* Vision changes