Antifibrinolytics

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)
Class Antifibrinolytic
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
Absorption 50% bioavailability
Distribution Low plasma protein binding, VD 9-12 litres
Metabolism Minimal hepatic metabolism
Elimination Renal of active drug - dose reduce in renal impairment
GIT Nausea, vomiting
Haematological Reduces fibrinolysis, possible increase in DVT/PE
Immunological Allergic dermatitis

References

  1. Peck TE, Hill SA. Pharmacology for Anaesthesia and Intensive Care. 4th Ed. Cambridge University Press. 2014.
  2. LITFL - Tranexamic Acid
Last updated 2017-08-02

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