Clinical summary
Drug/technique
Indications
Cautions
Side effects
Dose
Tranexamic acid
Prophylaxis for surgery that confers a high risk of bleeding or intervention for massive refractory intraoperative/postoperative bleeding
Absolute contraindications: allergy/hypersensitivity to the drug, ongoing acute venous or arterial thrombosis. Relative contraindications: patients with a history of thromboembolic disease or hereditary thrombophilia, concomitant use of hormonal oral contraceptives and other prothrombotic medications (including coagulation factor concentrates)
Headache, nausea, vomiting, diarrhea, dyspepsia, dizziness, back pain, numbness. In cardiac surgery, high doses of tranexamic acid are associated with an increased risk of postoperative generalized seizures (and patients with seizures have a higher mortality rate)
Intravenous administration
Slow loading dose before surgery over 20–30 min: 1–2 g or 10–30 mg/kg
Continuous infusion during surgery: 0.4–1 g/h or 1–16 mg/kg/h
References
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Hendrickson JE, Hillyer CD (2009) Noninfectious serious hazards of transfusion. Anesth Analg 108:759–769CrossRefPubMed
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