Heamic-T Special Precautions

The indication and method of administration indicated as follows should be followed strictly: Intravenous injections should be given very slowly.
Tranexamic acid should not be administered by the intramuscular route.
Due to the risk of cerebral oedema and convulsions, intrathecal or intraventricular injection and intracerebral application are contraindicated. In patients with a history of convulsion, tranexamic acid should not be administered.
In case of haematuria of renal origin, there is a risk of mechanical anuria due to formation of a ureteral clot.
In patients with renal insufficiency, because of the risk of accumulation. The dose should be reduced according to the following table: (See table.)

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In massive haematuria from the upper urinary tract (especially in haemophilia) since, in a few cases, ureteric obstruction has been reported.
In patients with disseminated intravascular coagulation (DIC), treatment must be restricted to those in whom there is predominant activation of the fibrinolytic system with acute severe bleeding. Characteristically, the haematological profile approximates to the following: reduced euglobulin clot lysis time; prolonged prothrombin time; reduced plasma levels of fibrinogen, factors V and VIII, plasminogen and alpha-2 macroglobulin; normal plasma levels of P and P complex; i.e. factors II (prothrombin), VIII and X; increased plasma levels of fibrinogen degradation products; a normal platelet count. The foregoing presumes that the underlying disease state does not of itself modify the various elements in this profile. In such acute cases, a single dose of 1g tranexamic acid is frequently sufficient to control bleeding. The fibrinolytic activity in the blood will be reduced for about 4 hours if renal function is normal. Anticoagulation with heparin should be instigated in order to prevent further fibrin deposition. Administration of Tranexamic Acid Solution for Injection in DIC should be considered only when appropriate haematological laboratory facilities and expertise are available. Tranexamic Acid Solution for Injection must not be administered in DIC with predominant activation of the coagulation system.
Before use of TXA, risk factors of thromboembolic disease should be investigated.
Tranexamic acid should be administered with care in patients receiving oral contraceptives because of the increased risk of thrombosis.