Haemorrhage or risk of haemorrhage in increased fibrinolysis or fibrinogenolysis. Local fribrinolysis may occur in menorrhagia, prostatectomy & bladder surgery, haematuria, GI haemorrhage, epistaxis, ulcerative colitis, conisation of the cervix & dental extraction in patients w/ coagulopathies. General fibrinolysis may occur in prostatic & pancreatic cancer, after thoracic & other major surgery, obstetrical complications eg, ablatio placentae & post-partum haemorrhage, leukemia, liver diseases, in connection w/ thrombolytic therapy w/ streptokinase. Hereditary angioneurotic oedema.
Recommended standard dose: 5-10 mL by slow IV inj at a rate of 1 mL/min bd-tds daily. General fibrinolysis 2 amp of 5 mL by slow IV inj every 6-8 hr. Prostatectomy 1-2 amp of 5 mL by slow IV inj every 6-8 hr (1st inj to be given during the operation) for the 1st 3 days after surgery. Epistaxis Soln for inj may be applied topically by soaking a gauze strip in the soln then packing the nasal cavity. Dental extraction in patient w/ coagulopathies 10 mg/kg IV immediately before surgery. After surgery, 25 mg/kg of an oral tranexamic acid 3-4 times daily for 6-8 days. Moderate to severe renal impairment serum creatinine >500 micromol/L IV dose: 5 mg/kg daily, 250-500 micromol/L 10 mg/kg daily, 120-249 micromol/L 10 mg/kg bd.
Do not use in patients w/ irregular menstrual bleeding. Patients w/ high risk for thrombosis; disseminated intravascular coagulation; convulsion. Dose reduction is recommended in patients w/ renal insufficiency. May influence the ability to drive or use machines. Pregnancy & lactation. Menorrhagic childn <15 yr.
Simultaneous treatment w/ anticoagulants. Caution w/ drugs that act on haemostasis. Potential risk of increased thrombus-formation eg, oestrogens. May antagonise the antifibrinolytic action w/ thrombolytics.
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