TXA

Section 8 - MEDICATION GUIDELINES

ANTI-FIBRINOLYTICS

Tranexamic Acid (TXA)

DESCRIPTION

• Inhibits both plasminogen activation and plasmin activity, thus preventing clot break-down rather than promoting new clot formation. With massive bleeding this may help stabilize clot formation and decrease extravascular bleeding.

INDICATIONS

• Severe Hemorrhagic Shock or imminent shock.
• Strongly consider in non-traumatic major bleeding (post-partum, gastrointestinal, postoperative, nasal) with signs of shock or imminent shock.

PREGNANCY CATEGORY

• B - Safe in Pregnancy
• Safe in breastfeeding

CONTRAINDICATION

• Hypersensitivity to TXA

RELATIVE CONTRAINDICATIONS

• Colorblindness
• History of Seizures
• Ischemic event: Myocardial Infarction, stroke, pulmonary embolism (PE), deep venous thrombosis (DVT)
• Isolated head injury / subarachnoid hemorrhage

PRECAUTIONS

• Rapid injection can cause hypotension

DOSAGE

• 1000 mg of TXA mixed in 100 ml or 250 ml of normal saline infused via IO or IV over 10 minutes.
• 20mg/kg (1000mg maximum) TXA mixed in 100 ml of Normal Saline infused via IO or IV over 10 minutes.