Tranexamic Acid Dosage

Medically reviewed by Drugs.com. Last updated on Aug 16, 2023.

Applies to the following strengths: 500 mg; 100 mg/mL; 650 mg; 10 mg/mL-NaCl 0.7%

Usual Adult Dose for Bleeding

Initial dose: 10 mg/kg intravenously, immediately before dental extraction
Maintenance dose: 10 mg/kg intravenously three to four times daily
Duration of therapy: 2 to 8 days

Comment: Infuse no more than 1 mL/minute to avoid hypotension.

Use: Short-term use in patients with hemophilia to reduce or prevent hemorrhage and reduce the need for replacement therapy during and following a tooth extraction.

Usual Adult Dose for Menstrual Disorders

Tablets:
Dose: 1300 mg (two 650 mg tablets) orally three times a day (3900 mg/day) during monthly menstruation
Duration: Maximum of 5 days

Use: For the treatment of cyclic heavy menstrual bleeding

Usual Pediatric Dose for Bleeding

Initial dose: 10 mg/kg intravenously, immediately before dental extraction
Maintenance dose: 10 mg/kg intravenously three to four times daily
Duration of therapy: 2 to 8 days

Comments:

The limited data suggest that dosing instructions for adults can be used for pediatric patients needing therapy for tooth extractions.
Infuse no more than 1 mL/minute to avoid hypotension.

Use: Short-term use in patients with hemophilia to reduce or prevent hemorrhage and reduce the need for replacement therapy during tooth extractions.

Usual Pediatric Dose for Menstrual Disorders

Tablets:
Dose: 1300 mg orally three times a day (3900 mg/day) during monthly menstruation

Duration: Maximum of 5 days

Use: For the treatment of cyclic heavy menstrual bleeding in post-menarchal females

Renal Dose Adjustments

Oral:
Serum creatinine above 1.4 mg/dL and less than or equal to 2.8 mg/dL: 1300 mg (two 650 mg tablets) two times a day for a maximum of 5 days during menstruation
Serum creatinine above 2.8 mg/dL and less than or equal to 5.7 mg/dL: 1300 mg (two 650 mg tablets) once a day for a maximum of 5 days during menstruation
Serum creatinine above 5.7 mg/dL: 650 mg (one 650 mg tablet) once a day for a maximum of 5 days during menstruation

Intravenous:
Serum creatinine 1.36 to less than 2.83 mg/dL: 10 mg/kg twice a day
Serum creatinine 2.83 to 5.66 mg/dL: 10 mg/kg once a day
Serum creatinine greater than 5.66 mg/dL: 5 mg/kg every 24 hours OR 10 mg/kg every 48 hours

Liver Dose Adjustments

No dose adjustment is needed.

Precautions

CONTRAINDICATIONS:
Intravenous injection:

Hypersensitivity to the active component or any of the ingredients
Patients with subarachnoid hemorrhage, due to risk of cerebral edema and cerebral infarction
Active intravascular clotting

Oral:

Hypersensitivity to the active component or any of the ingredients
Concomitant use with combination hormonal contraception
Active thromboembolic disease or a history or intrinsic risk of thrombosis or thromboembolism, including retinal vein or artery occlusion

The oral formulation is not indicated for use in women before menarche and is not intended for use by postmenopausal women.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

Intravenous infusion speed should be no more than 1 mL/minute to avoid hypotension.
The intravenous injection is for IV use only, and serious adverse reactions can occur if administered intrathecal or epidural (seizures and cardiac arrhythmias). Confirm route of administration and avoid confusion with other injectables and clearly label for IV route of administration.
For intravenous infusion, this drug may be mixed with solutions such as electrolyte, carbohydrate, amino acid and Dextran solutions. Heparin may also be added. DO NOT mix with blood or solutions containing penicillin.

Storage requirements:

The manufacturer product information should be consulted.

Patient advice:

This drug may cause dizziness. Avoid driving, operating machinery, or performing hazardous tasks while taking it until you know how will affect you.
Report any eye symptoms or changes in your vision to your healthcare provider and follow-up with an ophthalmologist for a complete ophthalmologic evaluation.
Female patients: Using hormonal contraception combined with tranexamic acid injection may increase the risk for thromboembolic adverse reactions. Consider using an effective alternative (nonhormonal) contraception during therapy.