Antifibrinolytics include aprotonin, aminocaproic acid, and transexamic acid. All prevent the breakdown of fibrin (!) by various mechanisms. TXA competitively inhibits plasminogen activator, reducing rate of fibrinolysis.
|Property||Tranexamic Acid (TXA)|
|Uses||Trauma (within 3 hours), cardiac surgery, obstetric surgery, and menorrhagia|
|Presentation||Tablets, syrup, clear colourless solution for injection|
|Route of Administration||IV, PO|
|Dosing||1g slow IV, which may be followed by infusion of 1g over 8 hours|
|Distribution||Low plasma protein binding, VD 9-12 litres|
|Metabolism||Minimal hepatic metabolism|
|Elimination||Renal of active drug - dose reduce in renal impairment|
|Haematological||Reduces fibrinolysis, possible increase in DVT/PE|
- Peck TE, Hill SA. Pharmacology for Anaesthesia and Intensive Care. 4th Ed. Cambridge University Press. 2014.
- LITFL - Tranexamic Acid