Tranexamic acid: Drug information
Copyright 1978-2018 Lexicomp, Inc. All rights reserved.
(For additional information see "Tranexamic acid: Patient drug information" and see "Tranexamic acid: Pediatric drug information")

For abbreviations and symbols that may be used in Lexicomp (show table)
Brand Names: US
  • Cyklokapron;
  • Lysteda
Brand Names: Canada
  • Cyklokapron;
  • GD-Tranexamic Acid;
  • Tranexamic Acid Injection;
  • Tranexamic Acid Injection BP
Pharmacologic Category
  • Antifibrinolytic Agent;
  • Antihemophilic Agent;
  • Hemostatic Agent;
  • Lysine Analog
Dosing: Adult

Cyclic heavy menstrual bleeding: Oral:

Lysteda: 1,300 mg 3 times daily (3,900 mg/day) for up to 5 days during monthly menstruation

Cyklokapron [Canadian product]: 1,000 to 1,500 mg 3 to 4 times daily

Tooth extraction in patients with hemophilia (in combination with appropriate factor replacement therapy): IV: 10 mg/kg immediately before surgery, then 10 mg/kg 3 to 4 times daily; may be used for 2 to 8 days

IV: 10 mg /kg as a single dose 2 hours prior to procedure (in conjunction with Factor VIII and IX); following procedure, administer oral tranexamic acid for 6 to 8 days

Oral: Cyklokapron [Canadian product]: 25 mg/kg as a single dose 2 hours prior to procedure, then 25 mg/kg 3 to 4 times daily for 6 to 8 days

Off-label uses:

Elective cesarean section, blood loss reduction (off-label use): IV: 1,000 mg over 5 minutes at least 10 minutes prior to skin incision (Gungorduk 2011)

Hereditary angioedema (HAE) (off-label use):

Long-term prophylaxis: Oral: 1,000 to 1,500 mg 2 to 3 times daily; reduce to 500 mg/dose once or twice daily when frequency of attacks reduces (Gompels 2005; Levy 2010) or 25 mg/kg/dose administered 2 to 3 times daily (Bowen 2004)

Short-term prophylaxis (eg, for dental work): Oral: 75 mg/kg/day divided 2 to 3 times daily for 5 days before and 2 days after the event (Bowen 2004) or 1,000 mg 4 times daily for 48 hours before and after procedure (Gompels 2005)

Treatment of acute HAE attack: Oral, IV: 25 mg/kg/dose (maximum single dose: 1,000 mg) every 3 to 4 hours (maximum: 75 mg/kg/day) (Bowen 2004) or 1,000 mg 4 times daily for 48 hours (Gompels 2005)

Hip fracture surgery, blood conservation (off-label use): IV: 15 mg/kg administered at the time of skin incision followed by a second dose (15 mg/kg) 3 hours later (Zufferey 2010). Additional data may be necessary to further define the role of tranexamic acid in this setting.

Intracranial hemorrhage associated with thrombolytics (plasminogen-activator) (eg, alteplase, reteplase, or tenecteplase) (off-label use): IV: 10 to 15 mg/kg over 20 minutes (as an alternative to cryoprecipitate); check fibrinogen levels after administration, if fibrinogen <150 mg/dL, cryoprecipitate is recommended (NCS/SCCM [Frontera 2016]).

Orthognathic surgery, blood loss reduction (off-label use): IV: 20 mg/kg over 15 minutes prior to incision (Choi 2009)

Perioperative blood loss reduction in bilateral total knee arthroplasty (off-label use): IV:

Three-dose regimen: 10 mg/kg administered as a slow IV infusion 30 minutes before tourniquet deflation for the first operation, 30 minutes before tourniquet deflation for the second operation, and 3 hours after commencement of the second dose (Kim 2014).

Two-dose regimen: 10 or 15 mg/kg administered over 10 minutes before deflation of the first tourniquet, with the second dose administered 3 hours after the first dose (MacGillivray 2011).

Perioperative blood loss reduction in unilateral total knee arthroplasty (off-label use): IV:

Intra- and postoperative regimen: 10 mg/kg at least 10 to 30 minutes prior to tourniquet release (deflation) and 10 mg/kg at 3 hours after the first dose (Alvarez 2008; Camarasa 2006; Maniar 2012). Instead of the second dose, a postoperative infusion may be administered at 1 mg/kg/hour for 6 hours (Alvarez 2008).

Pre- and intraoperative regimen: 10 mg/kg at least 20 minutes or immediately before tourniquet inflation and repeated at least 15 minutes prior to deflation or immediately after release of tourniquet (Lozano 2008; Maniar 2012).

Pre-, intra-, and postoperative regimen: 10 mg/kg at least 20 minutes before tourniquet inflation, repeated at least 15 minutes prior to deflation and postoperatively at 3 hours after the second dose (Maniar 2012).

Post-operative bleeding associated with cervical conization (prevention/reduction) (off-label use):

IV/Oral: Intra- and postoperative regimen: 1 g IV infusion during procedure followed by oral therapy 1 g 3 times daily for 14 days, beginning the day after procedure (Grunsdell 1984).

Oral: Postoperative regimen: 1500 mg every 8 hours beginning the evening following the procedure and continuing for 12 days (Rybo 1972).

Postpartum hemorrhage (off-label use): IV: 1,000 mg over 10 minutes given within 3 hours of vaginal birth or cesarean section; if bleeding continues after 30 minutes or stops and restarts within 24 hours after the first dose, a second dose of 1,000 mg may be given (WOMAN Trial Collaborators 2017).

Prevention of dental procedure bleeding in patients on oral anticoagulant therapy (off-label use): Oral rinse: 4.8% solution: Hold 10 mL in mouth and rinse for 2 minutes then spit out. Repeat 4 times daily for 2 days after procedure. Note: Patient should not eat or drink for 1 hour after using oral rinse (Carter 2003).

Prevention of perioperative bleeding associated with cardiac surgery (off-label use): IV: Loading dose of 30 mg/kg over 30 minutes (total loading dose includes a test dose administered over the first 10 minutes followed by the remainder of dose) prior to incision, followed by 16 mg/kg/hour until sternal closure; add an additional 2 mg/kg to cardiopulmonary bypass circuit (Fergusson 2008)

or

Loading dose of 10 mg/kg over 20 minutes prior to incision followed by 2 mg/kg/hour continued for 2 hours after transfer to ICU; add a prime dose of 50 mg for a 2.5 L cardiopulmonary bypass circuit; maintenance infusion adjusted for renal insufficiency (Nuttall 2008)

or

Loading dose of 10-15 mg/kg over 10 to 15 minutes, followed by 1 to 1.5 mg/kg/hour. The authors suggest adding 2 to 2.5 mg/kg to cardiopulmonary bypass circuit; however, amounts have varied widely in clinical trials (Gravlee 2008).

Prevention of perioperative bleeding associated with spinal surgery (eg, spinal fusion) (off-label use): IV: 2,000 mg over 20 minutes prior to incision followed by 100 mg/hour during surgery and for 5 hours postoperatively (Elwatidy 2008) or 10 mg/kg prior to incision followed by 1 mg/kg/hour for the remainder of the surgery; discontinue at time of wound closure (Wong 2008)

Total hip replacement surgery, blood conservation (off-label use): IV: 10 to 15 mg/kg (or 1,000 mg) administered over 5 to 10 minutes immediately before the operation or 15 minutes before skin incision; the preoperative dose may be followed by 10 mg/kg administered 3 to 12 hours after the operation. Postoperative doses ranged from a 10 mg/kg IV bolus (or 1,000 mg) to a 1 mg/kg/hour infusion over 10 hours (Gandhi 2013; Oremus 2014).

Note: Multiple regimens have been evaluated in varying degrees of evidence quality. The regimen listed here reflects the more commonly used dosing based on a number of prospective randomized controlled trials (Johansson 2005; McConnell 2011; Niskanen 2005; Oremus 2014). Metaanalyses have also been conducted demonstrating significant reduction in blood loss perioperatively without an increased risk of thromboembolic events (Gandhi 2013; Sukeik 2011; Zhou 2013). The use of intra-articular tranexamic acid (ie, 1,000 mg/50 mL of NaCl 0.9% sprayed into the wound at the end of the procedure) has also been evaluated demonstrating effectiveness (Alshryda 2014a; Alshryda 2014b).

Transurethral prostatectomy, blood loss reduction (off-label use): Oral: 2,000 mg 3 times daily on the operative and first postoperative day (Rannikko 2004)

Trauma-associated hemorrhage (off-label use): IV: Loading dose: 1,000 mg over 10 minutes, followed by 1,000 mg over the next 8 hours. Note: Clinical trial included patients with significant hemorrhage (SBP <90 mm Hg, heart rate >110 bpm, or both) or those at risk of significant hemorrhage. Treatment began within 8 hours of injury; however, every effort should be made to give as soon as possible (ideally within 3 hours of injury since treatment beyond 3 hours has been shown to be significantly less effective and may be associated with harm) (CRASH-2 Trial Collaborators 2010; CRASH-2 Trial Collaborators 2011).

Traumatic hyphema (off-label use): Oral: 25 mg/kg administered 3 times daily for 5 to 7 days (Rahmani, 1999; Vangsted, 1983; Varnek, 1980). Note: This same regimen may also be used for secondary hemorrhage after an initial traumatic hyphema event.

Dosing: Pediatric

(For additional information see "Tranexamic acid: Pediatric drug information")

Cyclic heavy menstrual bleeding: Children ≥12 years (postmenarche) and Adolescents: Oral: Refer to adult dosing.

Hereditary angioedema (HAE) (off-label use): Oral:

Long-term prophylaxis: 20 to 40 mg/kg/day in 2 to 3 divided doses (maximum dose: 3,000 mg daily) (Farkas 2007) or 50 mg/kg/day (or 1,000 to 2,000 mg daily; depending on age and size of patient); may consider alternate-day regimen or twice-weekly regimen when frequency of attacks reduces; diarrhea may be a dose-limiting side effect (Gompels 2005)

Short-term prophylaxis: 20 to 40 mg/kg/day in 2 to 3 divided doses (maximum dose: 3,000 mg daily) (Farkas 2007) or 500 mg 4 times daily (Gompels 2005). Note: For short-term prophylaxis (eg, dental work), initiate 2-5 days before and continue for 2 days after the procedure (Bowen 2004; Gompels 2005).

Prevention of perioperative bleeding associated with cardiac surgery (off-label use): IV: 10 mg/kg given over 30 minutes prior to incision, 10 mg/kg while on cardiopulmonary bypass, and 10 mg/kg administered after protamine reversal (Chauhan 2004a; Chauhan 2004b)

or

Loading dose of 100 mg/kg over 15 minutes prior to incision, followed by 10 mg/kg/hour infusion (continued until ICU transport); add 100 mg/kg to pump reservoir when cardiopulmonary bypass initiated (Reid, 1997)

Prevention of perioperative bleeding associated with craniosynostosis surgery (off-label use): IV: Loading dose of 50 mg/kg over 15 minutes prior to incision, followed by 5 mg/kg/hour (Goobie 2011) or 15 mg/kg over 15 minutes prior to incision, followed by 10 mg/kg/hour until skin closure (Dadure 2011)

Prevention of perioperative bleeding associated with spinal surgery (eg, spinal fusion) (off-label use): Children and Adolescents: IV: 10 mg/kg given over 15 minutes prior to incision followed by 1 mg/kg/hour for the remainder of the surgery; discontinue at time of wound closure (Neilipovitz 2001; Verma 2010)

or

100 mg/kg over 15 minutes prior to incision followed by 10 mg/kg/hour until skin closure (Sethna 2005)

or

30 mg/kg over 20 minutes prior to incision followed by 1 mg/kg/hour during surgery and for 5 hours postoperatively (Elwatidy 2008)

Tooth extraction in patients with hemophilia (in combination with appropriate factor replacement therapy): Children and Adolescents: IV: Refer to adult dosing.

Traumatic hyphema (off-label use): Oral: Refer to adult dosing.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment

IV formulation:

Tooth extraction in patients with hemophilia:

Serum creatinine 1.36 to 2.83 mg/dL: Maintenance dose of 10 mg/kg/dose twice daily

Serum creatinine 2.83 to 5.66 mg/dL: Maintenance dose of 10 mg/kg/dose once daily

Serum creatinine >5.66 mg/dL: Maintenance dose of 10 mg/kg/dose every 48 hours or 5 mg/kg/dose once daily

Cardiac surgery (the following dose adjustments have been recommended [Nuttall 2008]):

Serum creatinine 1.6 to 3.3 mg/dL: Reduce maintenance infusion to 1.5 mg/kg/hour (based on a 25% reduction from 2 mg/kg/hour)

Serum creatinine 3.3 to 6.6 mg/dL: Reduce maintenance infusion to 1 mg/kg/hour (based on a 50% reduction from 2 mg/kg/hour)

Serum creatinine >6.6 mg/dL: Reduce maintenance infusion to 0.5 mg/kg/hour (based on a 75% reduction from 2 mg/kg/hour)

Oral formulation:

Lysteda:

Serum creatinine >1.4 to 2.8 mg/dL: 1,300 mg twice daily (2,600 mg/day) for up to 5 days

Serum creatinine 2.9 to 5.7 mg/dL: 1,300 mg once daily for up to 5 days

Serum creatinine >5.7 mg/dL: 650 mg once daily for up to 5 days

Cyklokapron [Canadian product]:

Serum creatinine 1.4 to 2.8 mg/dL (120 to 250 micromol/L): 15 mg/kg twice daily

Serum creatinine 2.8 to 5.7 mg/dL (250 to 500 micromol/L): 15 mg/kg every 24 hours

Serum creatinine ≥5.7 mg/dL (≥500 micromol/L): 15 mg/kg every 48 hours

Dosing: Hepatic Impairment

No dosage adjustment is necessary.

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous:

Cyklokapron: 1000 mg/10 mL (10 mL)

Generic: 1000 mg/10 mL (10 mL)

Solution, Intravenous [preservative free]:

Generic: 1000 mg/10 mL (10 mL)

Tablet, Oral:

Lysteda: 650 mg

Generic: 650 mg

Generic Equivalent Available (US)

Yes

Dosage Forms: Canada

Information with regard to form, strength, and availability of products uniquely available in Canada but currently not available in the US. Refer also to Dosage forms.

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Cyklokapron: 500 mg

Administration

Injection: May be administered by direct IV injection at a maximum rate of 100 mg/minute (Crash-trial collaborators 2010; Elwatidy 2008; WOMAN Trial Collaborators 2017).

In general, do not inject more rapidly than 1 mL/minute to avoid hypotension.

Oral: Administer without regard to meals. Swallow tablet whole; do not break, chew, or crush.

Use

Cyclic heavy menstrual bleeding (oral): Treatment of cyclic heavy menstrual bleeding.

Tooth extraction in patients with hemophilia (injection, oral [Cyklokapron; Canadian product]): Short-term use in hemophilia patients to reduce or prevent hemorrhage and reduce need for replacement therapy during and following tooth extraction

Use: Off-Label

Bleeding associated with hip fracture surgery (prevention); Intracranial hemorrhage associated with thrombolytics (plasminogen-activator) (eg, alteplase, reteplase, or tenecteplase); Perioperative blood loss in total hip arthroplasty; Perioperative blood loss reduction in bilateral total knee arthroplasty; Perioperative blood loss reduction in unilateral total knee arthroplasty; Post-operative bleeding associated with cervical conization; Postpartum hemorrhage; Trauma-associated hemorrhage; Bleeding associated with dental procedures in patients on oral anticoagulant therapy (topical mouth rinse); Hereditary angioedema (long-term prophylaxis; acute treatment); Prevention of bleeding associated with cardiac surgery, craniosynostosis surgery, extracorporeal membrane oxygenation (ECMO), orthognathic surgery, spinal surgery (eg, spinal fusion), or transurethral prostatectomy; Reduction of blood loss associated with cesarean delivery; Traumatic hyphema

Medication Safety Issues
Sound-alike/look-alike issues:

Cyklokapron may be confused with cycloSPORINE

TXA (occasional abbreviation for tranexamic acid) is an error-prone abbreviation (mistaken as TNK an error-prone abbreviation for tenecteplase)

Adverse Reactions

>10%:

Central nervous system: Headache (oral: 50%)

Gastrointestinal: Abdominal pain (oral: 20%)

Neuromuscular & skeletal: Back pain (oral: 21%), musculoskeletal pain (oral: 11%)

Respiratory: Nasal signs and symptoms (oral: 25%; including sinus symptoms)

1% to 10%:

Central nervous system: Fatigue (oral: 5%)

Hematologic & oncologic: Anemia (oral: 6%)

Neuromuscular & skeletal: Arthralgia (oral: 7%), muscle cramps (oral: ≤7%), muscle spasm (oral: ≤7%)

<1%, postmarketing, and/or case reports: Allergic dermatitis, allergic skin reaction, anaphylactic shock, anaphylactoid reaction, anaphylaxis, cerebral thrombosis, chromatopsia, conjunctivitis (ligneous), deep vein thrombosis, diarrhea, dizziness, hypersensitivity reaction, hypotension (with rapid IV injection), nausea, pulmonary embolism, renal cortical necrosis, retinal artery occlusion, retinal vein occlusion, seizure, ureteral obstruction, visual disturbance, vomiting

Contraindications

US labeling:

Injection: Hypersensitivity to tranexamic acid or any component of the formulation; acquired defective color vision; active intravascular clotting; subarachnoid hemorrhage

Oral: Hypersensitivity to tranexamic acid or any component of the formulation; active thromboembolic disease (eg, cerebral thrombosis, DVT, or PE); history of thrombosis or thromboembolism, including retinal vein or retinal artery occlusion; intrinsic risk of thrombosis or thromboembolism (eg, hypercoagulopathy, thrombogenic cardiac rhythm disease, thrombogenic valvular disease); concurrent use of combination hormonal contraception

Canadian labeling: Injection, oral: Hypersensitivity to tranexamic acid or any component of the formulation; acquired defective color vision; history or risk of thrombosis (unless concurrent anticoagulation therapy is possible); active thromboembolic disease (eg, deep vein thrombosis, pulmonary embolism, cerebral thrombosis); subarachnoid hemorrhage; hematuria

Warnings/Precautions

Concerns related to adverse effects:

• CNS depression: May cause CNS depression, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).

• Hypersensitivity reactions: Severe hypersensitivity reactions, including anaphylaxis or anaphylactoid reaction have been reported.

• Ocular effects: Visual defects (eg, color vision change, visual loss) and retinal venous and arterial occlusions have been reported; discontinue treatment if ocular changes occur; prompt ophthalmic examination should be performed by an ophthalmologist. Use of the injection is contraindicated in patients with acquired defective color vision. Ligneous conjunctivitis has been reported with the oral formulation, but resolved upon discontinuation of therapy.

• Seizure: Seizures have been reported with use; most often with intraoperative use (eg, open chamber cardiac surgery) and in older patients (Murkin 2010). The mechanism by which tranexamic acid use results in seizures may be secondary to neuronal gamma aminobutyric acid (GABA) inhibition.

• Thrombotic events: Venous and arterial thrombosis or thromboembolism, including central retinal artery/vein obstruction, has been reported. Use the injection with caution in patients with thromboembolic disease; oral formulation is contraindicated in patients with a history of or active thromboembolic disease or with an intrinsic risk of thromboembolic events (eg, thrombogenic valvular disease, thrombogenic cardiac rhythm disease, hypercoagulopathy). Concomitant use with certain procoagulant agents (eg, anti-inhibitor coagulant complex/factor IX complex concentrates, oral tretinoin, hormonal contraceptives) may further increase the risk of thrombosis; concurrent use with either the oral or injectable formulation may be contraindicated, not recommended, or to be used with caution.

• Ureteral obstruction: Use the injection with caution in patients with upper urinary tract bleeding, ureteral obstruction due to clot formation has been reported.

Disease-related concerns:

• Disseminated intravascular coagulation (DIC): Use with extreme caution in patients with DIC requiring antifibrinolytic therapy; patients should be under strict supervision of a health care provider experienced in treating this disorder.

• Renal impairment: Use with caution in patients with renal impairment; dosage modification necessary.

• Subarachnoid hemorrhage: Use oral formulation with caution in patients with subarachnoid hemorrhage; cerebral edema and infarction may occur. Use of the injection is contraindicated.

• Vascular disease: Use with caution in patients with uncorrected cardiovascular or cerebrovascular disease due to the complications of thrombosis.

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

Metabolism/Transport Effects

None known.

Drug Interactions

(For additional information: Launch drug interactions program)

Anti-inhibitor Coagulant Complex (Human): Antifibrinolytic Agents may enhance the thrombogenic effect of Anti-inhibitor Coagulant Complex (Human). Risk X: Avoid combination

Estrogen Derivatives (Contraceptive): May enhance the thrombogenic effect of Tranexamic Acid. Risk X: Avoid combination

Progestins (Contraceptive): May enhance the thrombogenic effect of Tranexamic Acid. Risk X: Avoid combination

Tretinoin (Systemic): May enhance the thrombogenic effect of Antifibrinolytic Agents. Risk C: Monitor therapy

Pregnancy Risk Factor

B (show table)

Pregnancy Implications

Adverse events have not been observed in animal reproduction studies. Tranexamic acid crosses the placenta and concentrations within cord blood are similar to maternal concentrations. Tranexamic acid has been evaluated for the treatment of postpartum hemorrhage (Ducloy-Bouthors 2011; Gungorduk 2011; WOMAN Trial Collaborators 2017). A significant reduction in risk of death due to bleeding was observed when treatment was started within 3 hours of vaginal birth or cesarean section (WOMAN Trial Collaborators 2017). Oral tranexamic acid (Lysteda) is not indicated for use in pregnant women.

Breast-Feeding Considerations

Tranexamic acid is present in breast milk. Concentrations are approximately 1/100th of the maximum maternal serum concentration. Breastfeeding is not recommended by the manufacturer.

Monitoring Parameters

Ophthalmic examination (visual acuity, color vision, eye-ground, and visual fields) at baseline and regular intervals during the course of therapy in patients being treated for longer than several days; signs/symptoms of hypersensitivity reactions, seizures, thrombotic events, and ureteral obstruction

Mechanism of Action

Forms a reversible complex that displaces plasminogen from fibrin resulting in inhibition of fibrinolysis; it also inhibits the proteolytic activity of plasmin

With reduction in plasmin activity, tranexamic acid also reduces activation of complement and consumption of C1 esterase inhibitor (C1-INH), thereby decreasing inflammation associated with hereditary angioedema.

Pharmacodynamics/Kinetics

Distribution: Vd: 9 to 12 L; CSF levels are 10% of plasma

Protein binding: ~3%, primarily to plasminogen

Bioavailability: Oral: ~45%

Half-life elimination: ~2 to 11 hours

Time to peak: Oral: 2.5 hours (range: 1 to 5 hours)

Excretion: Urine (>95% as unchanged drug)

Pricing: US

Solution (Cyklokapron Intravenous)

1000 mg/10 mL (10 mL): $50.40

Solution (Tranexamic Acid Intravenous)

1000 mg/10 mL (10 mL): $24.00

Tablets (Lysteda Oral)

650 mg (30): $174.00

Tablets (Tranexamic Acid Oral)

650 mg (30): $156.43

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International
  • Amchafibrin (ES);
  • Anaxyl (BD);
  • Aneptil (LK);
  • Azeptil (TR);
  • Bionex (BD);
  • Caprilon (FI);
  • Ciclokapron (VE);
  • Cyclokapron (IS, LU, MT);
  • Cyklokapron (AE, AT, AU, BB, BH, CH, CY, DE, DK, EE, EG, ET, FI, GB, IE, IQ, IR, JO, KW, LB, LY, NL, NO, NZ, OM, QA, SA, SE, SG, SY, YE, ZA);
  • Duhemos (VN);
  • Espercil (CL);
  • Exacyl (AE, BE, CZ, FR, HN, LB, LU, PL);
  • Fimoplas (PH);
  • Haemostop (SG);
  • Hemisan (VN);
  • Hemoblock (EC);
  • Hemoclot (PH);
  • Hemostan (PH);
  • Hemotrex (PH);
  • Hexakapron (IL);
  • Kalnex (ID);
  • Lunex (ID);
  • Medsamic (VN);
  • Nexa (ID);
  • Nobleed (LK);
  • Qualixamin (HK);
  • Ranexid (PH);
  • Rikaparin (TW);
  • Ronex (ID);
  • Tiren (MY);
  • Tracid (BD);
  • Tramic (TH);
  • Tranarest (IN);
  • Tranestat (UA);
  • Tranex (BD, IT);
  • Tranexam (RU, TW);
  • Tranexic (TW);
  • Tranexid (ID);
  • Tranlok (LK);
  • Tranmix (VN);
  • Transamin (BR, CN, HK, JP, KR, MY, PE, PK, TH, TW, VN);
  • Transamina (UY);
  • Transic (TH);
  • Tranxa (ID);
  • Trenaksa (UA);
  • Trenaxin (PH);
  • Vydanol (UA)
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REFERENCES

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  2. Alshryda S, Mason J, Vaghela M, et al. Topical (intra-articular) tranexamic acid reduces blood loss and transfusion rates following total knee replacement: a randomized controlled trial (TRANX-K). J Bone Joint Surg Am. 2013b;95(21):1961-1968. doi: 10.2106/JBJS.L.00907. [PubMed 24196466]
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  11. CRASH-2 collaborators, Roberts I, Shakur H, et al. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet. 2011;377(9771):1096-1101, 1101.e1-e2. doi: 10.1016/S0140-6736(11)60278-X. [PubMed 21439633]
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  13. Cyklokapron (tranexamic acid) (prescribing information). New York, NY: Pharmacia & Upjohn Company; November 2017.
  14. Cyklokapron (tranexamic acid) [product monograph]. Kirkland, Quebec, Canada: Pfizer Canada Inc; February 2016.
  15. Dadure C, Sauter M, Bringuier S, et al, “Intraoperative Tranexamic Acid Reduces Blood Transfusion in Children Undergoing Craniosynostosis Surgery: A Randomized Double-Blind Study,” Anesthesiology, 2011, 114(4):856-61. [PubMed 21358317]
  16. Dhillon MS, Bali K, Prabhakar S. Tranexamic acid for control of blood loss in bilateral total knee replacement in a single stage. Indian J Orthop. 2011;45(2):148-152. doi: 10.4103/0019-5413.77135. [PubMed 21430870]
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  19. Eaton MP, "Antifibrinolytic Therapy in Surgery for Congenital Heart Disease," Anesth Analg, 2008, 106(4):1087-100. [PubMed 18349177]
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