Tranexam - instructions for use, reviews, analogs and forms of release (tablets 250 mg and 500 mg, injections in ampoules) for the treatment of bleeding during surgery, during menstruation in adults, children and pregnancy

In this article, you can read the instructions for using the drug Tranexam. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Tranexam in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Tranexam in the presence of existing structural analogs. Use to treat bleeding during surgery, during menstruation in adults, children, as well as during pregnancy and lactation.

Tranexam haemostatic drug. Inhibitor of fibrinolysis. Specifically inhibits the activation of plasminogen and its transformation into plasmin. Has a local and systemic hemostatic effect in bleeding associated with increased fibrinolysis (platelet pathology, menorrhagia).

By suppressing the formation of kinins and other active peptides involved in allergic and inflammatory reactions, it has anti-allergic and anti-inflammatory effects.

In experimental studies, the own analgesic activity of tranexamic acid has been confirmed, as well as a potentiating effect on the analgesic activity of opioid analgesics.

Composition

Tranexamic acid + auxiliary substances.

Pharmacokinetics

If administered orally, a dose of 0.5-2 g absorbs 30-50% of the drug. It is distributed in tissues relatively evenly (with the exception of cerebrospinal fluid, where the concentration is 1/10 of the plasma one). Penetrates through the placental barrier and the blood-brain barrier (GEB), excreted in breast milk (reaching approximately 1% of the concentration in the mother's plasma).It is found in seminal fluid, where it reduces fibrinolytic activity, but does not affect the migration of spermatozoa. It is excreted by the kidneys (the main way is glomerular filtration), more than 95% unchanged during the first 12 hours.

Indications

• bleeding or the risk of bleeding on the background of generalized fibrinolysis (bleeding during surgery and postoperative period, postpartum bleeding, manual detachment, chorion detachment, bleeding during pregnancy, malignant neoplasms of the pancreas and prostate gland, hemophilia, hemorrhagic complications of fibrinolytic therapy, thrombocytopenic purpura , leukemia, liver disease, previous therapy with streptokinase);
• bleeding or the risk of bleeding on the background of local strengthening of fibrinolysis (uterine, nasal, gastrointestinal bleeding, hematuria, bleeding after prostatectomy, conization of the cervix due to carcinoma, extraction of the tooth in patients with hemorrhagic diathesis);
• hereditary angioedema (for tablets);
• allergic diseases, incl.eczema, allergic dermatitis, urticaria, drug and toxic rash (for tablets);
• inflammatory diseases of the oral cavity and pharynx, including tonsillitis, pharyngitis, laryngitis, stomatitis, aphthae of the oral mucosa (for tablets);
• surgical interventions on the bladder (for the solution);
• Surgical manipulations with a systemic inflammatory reaction, incl. sepsis, peritonitis, pancreonecrosis, severe and moderate severity of gestosis, shock of various etiologies (for solution).

Forms of release

Tablets coated with 250 mg and 500 mg.

Solution for intravenous administration (injections in ampoules for injection).

Instructions for use and dosage

Pills

The drug is prescribed inside.

With local fibrinolysis appoint 1-1.5 g 2-3 times a day.

With profuse uterine bleeding appoint 1-1.5 g 3-4 times a day for 3-4 days.

When bleeding against the background of von Willebrand disease and other coagulopathies - 1-1.5 g 3-4 times a day for 3-10 days.

After the operation of conization of the cervix - 1.5 g 3 times a day for 12-14 days.

With nasal bleeding - 1 g 3 times a day for 7 days.

Patients with coagulopathies after extraction of the tooth - 1-1.5 g 3-4 times a day for 6-8 days.

When bleeding during pregnancy, appoint - 250-500 mg 3-4 times a day until the complete stop of bleeding. The average duration of the course of treatment is 7 days.

With hereditary angioedema, 1-1.5 g 2-3 times a day, continuously or intermittently, depending on the presence of prodromal symptoms.

With the symptoms of allergy and inflammation - 1-1.5 g 2-3 times a day for 3-9 days, depending on the severity of the condition.

With generalized fibrinolysis, therapy begins with parenteral intravenous administration followed by a transition to oral administration at a dose of 1-1.5 g 2-3 times a day.

Ampoules

Intravenous (drip (dropper), jet). When generalized fibrinolysis is administered in a single dose of 15 mg / kg body weight every 6-8 hours, the rate of administration is 1 ml / min. With local fibrinolysis, the administration of the drug in a dose of 250-500 mg 2-3 times a day is recommended. When prostatectomy or surgery on the bladder is administered during the operation, 1 g, then 1 g every 8 hours for 3 days, after which they switch to the inside of the tablet form until the disappearance of the macrohematuria.

With a high risk of bleeding, with a systemic inflammatory reaction at a dose of 10-11 mg / kg for 20-30 minutes before the intervention.

Patients with coagulopathies before the extraction of the tooth are administered at a dose of 10 mg / kg of body weight, after extraction of the tooth, the intake, the tablet form of the preparation, is prescribed.

In case of disturbance of the excretory function of the kidneys, correction of the dosing regimen is necessary: ​​at a creatinine concentration of 120-250 μmol / l, 10 mg / kg twice a day are prescribed; at a creatinine concentration of 250-500 μmol / l, 10 mg / kg once a day is prescribed; at a creatinine concentration of more than 500 μmol / l administered at 5 mg / kg once a day.

Side effect

• anorexia;
• nausea, vomiting;
• heartburn;
• diarrhea;
• dizziness;
• weakness;
• drowsiness;
• violation of color perception;
• blurred vision;
• thrombosis and thromboembolism;
• tachycardia;
• pain in the chest;
• arterial hypotension (with rapid intravenous administration);
• skin rash;
• itching;
• hives.

Contraindications

• subarachnoid hemorrhage;
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

It is used in pregnancy according to indications with obligatory allowance for contraindications, tranexamic acid penetrates the placental barrier and is excreted in breast milk (reaching approximately 1% of the concentration in the mother plasma).

special instructions

Before and during the treatment, the ophthalmologist should be examined for visual acuity, color perception, and the condition of the fundus.

Drug Interactions

When combined with hemostatic drugs and hemocoagulase, thrombus formation can be activated.

The solution for intravenous administration is pharmaceutically incompatible with blood preparations, solutions containing penicillin, urokinase, hypertensive agents (norepinephrine, deoxyepinefrin hydrochloride, metarnin bitartrate), tetracyclines, dipyridamole, diazepam.

Caution should be used in combination with Heparin and anticoagulants in patients with impaired coagulation and thrombosis (cerebral vascular thrombosis, myocardial infarction, thrombophlebitis) or the threat of their development.

Analogues of the drug Tranexam

Structural analogs for the active substance:

• Tranexamic acid;
• Transacha;
• Troxaminate;
• Exacil.

Analogues for the pharmacological group (inhibitors of fibrinolysis):

• Amben;
• Aminocaproic acid;
• Aprotex;
• Aprotinin;
• Aeros;
• Vero Narkap;
• Gordoks;
• Gumbix;
• Inhistril;
• Contrikal;
• Pamba;
• Polycapra;
• Trasilol 500,000;
• Traskolan.

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