Tranexamic Acid
Tranexamic acid is used as an adjunct to control bleeding when excessive fibrinolysis is suspected or demonstrated.
Group
Antifibrinolytic; lysine analogue
Mechanism of Action
Blocks lysine-binding sites on plasminogen, limiting plasmin-mediated fibrin breakdown.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Hyperfibrinolytic haemorrhage | 10–15 mg/kg | IV | Every 8 h | Administer diluted and slowly. Reassess the need for repeated treatment. |
| Hyperfibrinolytic haemorrhage with infusion — Loading | 10 mg/kg | IV | Once | Loading dose before the associated infusion; give slowly. |
| Hyperfibrinolytic haemorrhage with infusion — Maintenance | 10 mg/kg/hour | IV | Continuous | Continue for 3 hours after the loading dose. |
Indications
- Hyperfibrinolytic haemorrhage
Contraindications
- Active intravascular thrombosis; assess the cause of coagulopathy before treatment.
Interactions
- Other procoagulants may increase thrombosis risk; aminocaproic acid duplicates antifibrinolytic treatment.
Adverse effects
- Vomiting, especially after rapid IV administration.
- Hypotension or hypersensitivity; seizures are possible with excessive exposure.
Toxicity
Stop treatment after suspected toxicity; support circulation and control seizures. Reduced renal clearance can increase exposure.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Tranexamic acid injection 100 mg/mL Human injectable presentation; not an epidural or intrathecal preparation. | Injection | 100 mg / mL | IV |
Monitoring and Administration
Assess bleeding, perfusion, haematocrit, renal function and, where available, viscoelastic evidence of fibrinolysis.
Dilute and administer IV doses slowly; treatment does not replace surgical haemostasis or indicated blood products.