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Tranexamic acid parenteral


Injections of tranexamic acid.

Drugs List

  • CYKLOKAPRON 500mg/5ml injection
  • tranexamic acid 1g/10ml solution for injection ampoule
  • tranexamic acid 500mg/5ml injection
  • Therapeutic Indications


    General fibrinolysis: treatment
    Local fibrinolysis: short-term treatment
    Prevention of local fibrinolysis

    Prevention or treatment of haemorrhage due to fibrinolysis.

    Indications include:
    Menorrhagia and metrorrhagia
    Gastrointestinal bleeding
    Haemorrhagic urinary disorders
    Ear, nose or throat surgery
    Gynaecological surgery or disorders of obstetric origin
    Thoracic, abdominal or cardiovascular surgery
    Management of haemorrhage due to the administration of a fibrinolytic agent.

    Unlicensed Uses

    Haemorrhage following trauma
    Hereditary angioedema



    Local fibrinolysis
    The usual dosage is 500mg to 1g by slow intravenous injection (1ml/minute) two to three times daily.
    This may be followed by 25 to 50mg/kg/day by intravenous (unlicensed).

    General fibrinolysis
    1g tranexamic acid by slow intravenous injection (1ml/minute) every 6 to 8 hours, equivalent to 15mg/kg body weight.

    Treatment and prevention of trauma-induced haemorrhage (unlicensed)
    Initial dose: 1g given over ten minutes by intravenous injection. Start within 8 hours of the trauma.
    Maintenance dose: 1g given over 8 hours by continuous intravenous infusion (unlicensed).


    Children aged 1 year and older
    The dosage is in the region of 20mg/kg/day. However, data on efficacy, posology and safety are limited.

    The following alternative unlicensed dosage schedule may be suitable:

    Inhibition of fibrinolysis, hereditary angioedema
    By intravenous injection over at least 10 minutes
    10mg/kg (maximum per dose 1g), two to three times daily.

    By continuous intravenous infusion (unlicensed)
    45mg/kg, dose to be given over 24 hours.

    Prevention of excessive bleeding after dental procedures (e.g. in haemophilia)
    By intravenous injection pre-operatively
    Children aged 6 to 18 years: 10mg/kg (maximum per dose 1.5g).

    Patients with Renal Impairment

    The manufacturer recommends the dosage should be reduced as follows:
    Serum creatinine 120 to 249micromole/L: 10mg/kg every 12 hours.
    Serum creatinine 250 to 500micromole/L: 10mg/kg every 24 hours.
    Serum creatinine greater than 500micromole/L: 5mg/kg every 24 hours.

    The Renal Drug Handbook suggests the following doses:
    Glomerular filtration rate (GFR)
    GFR 20 to 50mL/minute: 10mg/kg 12 hourly.
    GFR 10 to 20mL/minute: 10mg/kg 24 hourly.
    GFR less than 10mL/minute: 5mg/kg 24 hourly.


    For slow intravenous injection or infusion (1ml/minute) or continuous intravenous infusion (unlicensed) administration.


    Disseminated intravascular coagulation without reactive major fibrinolysis
    First trimester of pregnancy
    History of seizures
    Severe renal impairment
    Thromboembolic disorder

    Precautions and Warnings

    Children aged 1 month to 1 year
    Family history of thromboembolic disorder
    Females of childbearing potential
    Undiagnosed irregular menstrual bleeding
    History of thromboembolic disorder
    Renal impairment
    Second trimester of pregnancy
    Third trimester of pregnancy

    Reduce dose in patients with renal impairment
    Do not mix with other drugs or substances
    During prolonged therapy eye examinations are advisable
    Monitor hepatic function in patients with hereditary angioneurotic oedema
    Advise patient to report any blurred vision or any other eye symptoms
    Discontinue if any kind of visual disturbance occurs
    Female: Ensure adequate contraception during treatment

    Massive haemorrhage from upper urinary tract, risk of urethral obstruction has been reported (especially in haemophilia).

    Before use of tranexamic acid, risk factors for thromboembolic disease should be investigated.

    Tranexamic acid should be administered with care in patients receiving oral contraceptives due to an increased risk of thrombosis.

    Tranexamic acid should only be considered in patients with disseminated intravascular coagulation when appropriate haematological laboratory facilities are available.

    Pregnancy and Lactation


    Use tranexamic acid with caution during pregnancy.

    The manufacturer does not recommend using tranexamic acid during the first trimester of pregnancy, and should only be used throughout pregnancy if the expected benefit justifies the potential risk. At the time of writing there is limited published information regarding the use of tranexamic acid during pregnancy. Potential risks are unknown.


    Tranexamic acid is contraindicated during breastfeeding.

    Use of tranexamic acid when breastfeeding is contraindicated by the manufacturer. Tranexamic acid is present in human breast milk. Effects on exposed infants are unknown.

    Side Effects

    Allergic skin reactions
    Arterial thrombosis
    Hypersensitivity reactions
    Impaired consciousness
    Macular degeneration of colour vision
    Venous thrombosis
    Visual disturbances


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: August 2021

    Reference Sources

    Summary of Product Characteristics: Cyklokapron injection. Pharmacia Ltd. Revised March 2019.

    Summary of Product Characteristics: Tranexamic acid 500mg/5ml solution for injection. Focus Pharmaceuticals Ltd. Revised June 2015.
    Summary of Product Characteristics: Tranexamic acid 1g/10ml solution for injection ampoules. Bowmed Ibisqus Limited. Revised January 2020.

    NICE Evidence Services Available at: Last accessed: 11 August 2021

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