Tranexid Uses

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What is Tranexid?

Tranexid injection is used to control or prevent excessive or heavy bleeding during dental procedures in patients with hemophilia. Tranexid is for short-term use only, usually 2 to 8 days.

Tranexid injection is an antifibrinolytic agent. It works by blocking the breakdown of blood clots. It may also be used for other conditions as determined by your doctor.

Tranexid is available only with your doctor's prescription.

Tranexid indications

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For short-term use (2-8 days) in haemophilia patients to reduce or prevent haemorrhage and to reduce the need for replacement therapy during and following tooth extraction.

For many haemostatic purposes including prevention of bleeding after surgery of trauma (eg, tonsillectomy and adenoidectomy, prostatic surgery, ocular trauma and cervical conisation), and to prevent rebleeding of subarachnoid haemorrhage, spontaneous bleeding in haemophilia and spontaneous or postoperative corneal oedema.

To treat primary or intrauterine device (IUD)-induced menorrhagia, gastric and intestinal haemorrhage, recurrent epistaxis and hereditary angioneurotic oedema. Tranexid also inhibits induced hyperfibrinolysis during thrombolytic treatment with plasminogen activators.

How should I use Tranexid?

Use Tranexid as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Tranexid.

Uses of Tranexid in details

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Use: Labeled Indications

Menstrual bleeding, heavy (oral): Treatment of cyclic heavy menstrual bleeding.

Tooth extraction in patients with hemostatic defects (injection, oral [Tranexid; Canadian product]): Short-term use in hemophilia patients to reduce or prevent hemorrhage and reduce need for replacement therapy during and following tooth extraction.

Off Label Uses

Dental procedures in patients on oral anticoagulant therapy

Based on the American College of Chest Physicians guidelines for perioperative management of antithrombotic therapy, Tranexid is recommended to use, when needed, in combination with the continuation of oral anticoagulant therapy for the perioperative management of patients who require minor procedures.

Hemoptysis (nonmassive), treatment

Data from a small, single-center, prospective, randomized, double-blind, placebo-controlled trial suggest that nebulized Tranexid may be beneficial for the control of nonmassive hemoptysis by reducing the duration and volume of bleeding, with a low risk for side effects.

Tranexid description

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Each capsule also contains sodium bisulfite, sodium lauryl sulfate and Yellow No.5 (Sunset Yellow FCF) as inactive ingredients. Each 5% w/v ampoule contains Tranexamic Acid 250 mg/5 mL, has a pH of 7-8 and an osmotic pressure ratio (with respect to physiological saline) of about 1.

Each 10% w/v ampoule contains Tranexamic Acid 250 mg/2.5 mL, has a pH of 7-8 and an osmotic pressure ratio (with respect to physiological saline) of about 2.

Tranexid is trans-4-aminomethylcyclohexanecarboxylic acid. It has a molecular formula of C8H15NO2, molecular weight of 157.21 and melting point of 386-390°C (decomposition). It occurs as white crystals or powder, odorless and has bitter taste. It is freely soluble in water or glacial acetic acid; very slightly soluble in ethanol; practically insoluble in ether; soluble in sodium hydroxide TS.

Capsule Size: No.2, total length of 17.6 mm and weight of about 350 mg.

Tranexid dosage

Tranexid Dosage

Generic name: Tranexid 100mg in 1mL

Dosage form: injection, solution

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Immediately before tooth extraction in patients with hemophilia, administer 10 mg per kg body weight of Tranexid intravenously together with replacement therapy. Following tooth extraction, intravenous therapy, at a dose of 10 mg per kg body weight three to four times daily, may be used for 2 to 8 days.

Note: For patients with moderate to severe impaired renal function, the following dosages are recommended:

Serum Creatinine (µmol/L) Tranexid

Intravenous Dosage

120 to 250 (1.36 to 2.83 mg/dL) 10 mg/kg twice daily
250 to 500 (2.83 to 5.66 mg/dL) 10 mg/kg daily
>500 (>5.66 mg/dL) 10 mg/kg every 48 hours

or

5 mg/kg every 24 hours

For intravenous infusion, Tranexid Injection may be mixed with most solutions for infusion such as electrolyte solutions, carbohydrate solutions, amino acid solutions, and Dextran solutions. Heparin may be added to Tranexid Injection. Tranexid Injection should NOT be mixed with blood. The drug is a synthetic amino acid, and should NOT be mixed with solutions containing penicillin.

Single-dose vials and ampules

Discard Tranexid vial or ampule and any remaining portion in the vial/ampule after single use.

The diluted mixture may be stored for up to 4 hours at room temperature prior to patient administration.

More about Tranexid (Tranexid)

Consumer resources

Professional resources

Related treatment guides

Tranexid interactions

See also:
What other drugs will affect Tranexid?

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Contraindications for Co-Administration: Tranexid should not be co-adminstered with thrombin. Co-administration may cause a thrombosis tendency. It increases the tendency towards thrombosis due to the thrombogenic property of Tranexid.

Precautions for Co-Administration: Tranexid should be administered with care when co-administered with the following drugs.

Hemocoagulase: Co-administration at high doses may cause a thrombosis tendency. Due to the antiplasmin action of Tranexid, fibrin clots formed by hemocoagulase may persist in the blood stream for a relatively long period of time, which may result in a prolonged thrombotic state.

Batroxobin: Co-administration may cause thromboembolism. Tranexid inhibits the decomposition of desA fibrin polymer produced by batroxobin.

Coagulation Factor Agents (Eptacog-α): Coagulation may be further activated at sites with enhanced local fibrinolysis eg, the oral cavity. Coagulation factors exert hemostatic actions by activating the coagulation system, where as Tranexid exerts hemostatic actions by inhibiting the fibrinolytic system.

Tranexid side effects

See also:
What are the possible side effects of Tranexid?

Clinical Trial Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to the rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

Short-term Studies

The safety of Tranexid Tablets in the treatment of heavy menstrual bleeding (HMB) was studied in two randomized, double-blind, placebo-controlled studies. One study compared the effects of two doses of Tranexid Tablets (1950 mg and 3900 mg given daily for up to 5 days during each menstrual period) versus placebo over a 3-cycle treatment duration. A total of 304 women were randomized to this study, with 115 receiving at least one dose of 3900 mg/day of Tranexid Tablets. A second study compared the effects of Tranexid Tablets (3900 mg/day) versus placebo over a 6-cycle treatment duration. A total of 196 women were randomized to this study, with 117 receiving at least one dose of Tranexid Tablets. In both studies, subjects were generally healthy women who had menstrual blood loss of ≥ 80 mL.

In these studies, subjects were 18 to 49 years of age with a mean age of approximately 40 years, had cyclic menses every 21-35 days, and a BMI of approximately 32 kg/m2. On average, subjects had a history of HMB for approximately 10 years and 40% had fibroids as determined by transvaginal ultrasound. Approximately 70% were Caucasian, 25% were Black, and 5% were Asian, Native American, Pacific Islander, or Other. Seven percent (7%) of all subjects were of Hispanic origin. Women using hormonal contraception were excluded from the trials.

The rates of discontinuation due to adverse events during the two clinical trials were comparable between Tranexid Tablets and placebo. In the 3-cycle study, the rate in the 3900 mg Tranexid Tablets dose group was 0.8% as compared to 1.4% in the placebo group. In the 6-cycle study, the rate in the Tranexid Tablets group was 2.4% as compared to 4.1% in the placebo group. Across the studies, the combined exposure to 3900 mg/day Tranexid Tablets was 947 cycles and the average duration of use was 3.4 days per cycle.

A list of adverse events occurring in ≥ 5% of subjects and more frequently in Tranexid Tablets treated subjects receiving 3900 mg/day compared to placebo is provided in Table 2.

Long-term Studies

Long-term safety of Tranexid Tablets was studied in two open-label studies. In one study, subjects with physician-diagnosed heavy menstrual bleeding (not using the alkaline hematin methodology) were treated with 3900 mg/day for up to 5 days during each menstrual period for up to 27 menstrual cycles. A total of 781 subjects were enrolled and 239 completed the study through 27 menstrual cycles. A total of 12.4% of the subjects withdrew due to adverse events. Women using hormonal contraception were excluded from the study. The total exposure in this study to 3900 mg/day Tranexid Tablets was 10,213 cycles. The average duration of Tranexid Tablets use was 2.9 days per cycle.

A long-term open-label extension study of subjects from the two short-term efficacy studies was also conducted in which subjects were treated with 3900 mg/day for up to 5 days during each menstrual period of up to 9 menstrual cycles. A total of 288 subjects were enrolled and 19% subjects completed the study through 9 menstrual cycles. A total of 2.1% of the subjects withdrew due to adverse events. The total exposure to 3900 mg/day Tranexid Tablets in this study was 1,956 cycles. The average duration of Tranexid Tablets use was 3.5 days per cycle.

The types and severity of adverse events in these two long-term open-label trials were similar to those observed in the double-blind, placebo-controlled studies although the percentage of subjects reporting them was greater in the 27-month study, most likely because of the longer study duration.

A case of severe allergic reaction to Tranexid Tablets was reported in the extension trial, involving a subject on her fourth cycle of treatment, who experienced dyspnea, tightening of her throat, and facial flushing that required emergency medical treatment.

Postmarketing Experience

The following adverse reactions have been identified from postmarketing experience with Tranexid. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Based on US and worldwide postmarketing reports, the following have been reported in patients receiving Tranexid for various

Indications:

Tranexid contraindications

See also:
What is the most important information I should know about Tranexid?

Thromboembolic Risk

​Do not prescribe Tranexid Tablets to women who are

Venous and arterial thrombosis or thromboembolism, as well as cases of retinal artery and retinal vein occlusions, have been reported with Tranexid.

Hypersensitivity to Tranexid

Do not prescribe Tranexid Tablets to women with known hypersensitivity to Tranexid.

Active ingredient matches for Tranexid:

Tranexamic Acid in Indonesia.


Unit description / dosage (Manufacturer)Price, USD
Tranexid 250 mg x 100's$ 13.02
Tranexid 500 mg x 100's$ 21.82
Tranexid 50 mg/1 mL x 10's$ 7.81
Tranexid 100 mg/1 mL x 5 mL x 10's$ 11.04

List of Tranexid substitutes (brand and generic names):

Tranexic 250 mg x 1000's
Tranexmin 250 mg
Tranexmin 250 mg x Blister pk
Tranexure 500mg Injection (BB Remedies Pvt Ltd)$ 0.46
TRANFIB Capsule/ Tablet / 500mg / 10 units (Cipla Limited)$ 1.27
TRANFIB Injection / 100mg per ml / 5ml units (Cipla Limited)$ 0.48
Tranfib 100mg/ml INJ / 5ml (Cipla Limited)$ 0.49
500 mg x 10's (Cipla Limited)$ 1.27
Tranfib 500 mg Tablet (Cipla Limited)$ 0.13
TRANFIB film-coated tab 500 mg x 10's (Cipla Limited)$ 1.27
TRANFIB inj 500 mg x 5ml (Cipla Limited)
Tranfib 100mg/ml Injection (Cipla Limited)$ 0.10
Tranfib Inj 500 mg Injection (Cipla Limited)$ 0.10
Trankos 250mg INJ / 5ml (Elkos)
TRANKOS inj 250 mg x 5ml (Elkos)
Tranlok 500 mg Injection (Otsira Genetica (Aristo Pharmaceuticals Pvt Ltd.))$ 0.47
TRANLOK 500 MG INJECTION 1 vial / 5 ML injection each (Otsira Genetica (Aristo Pharmaceuticals Pvt Ltd.))$ 0.61
Tranlok 500mg Injection (Otsira Genetica (Aristo Pharmaceuticals Pvt Ltd.))$ 0.12
Tranlok M 500+250 Tablet (Otsira Genetica (Aristo Pharmaceuticals Pvt Ltd.))$ 0.13
TRANLOK M 500 MG/250 MG TABLET 1 strip / 10 tablets each (Otsira Genetica (Aristo Pharmaceuticals Pvt Ltd.))$ 1.95
Tranlok M 500 mg/250 mg Tablet (Otsira Genetica (Aristo Pharmaceuticals Pvt Ltd.))$ 0.19
Tranlok Tab 500 mg Tablet (Otsira Genetica (Aristo Pharmaceuticals Pvt Ltd.))$ 0.10
Tranmix 5 % x 10 tube 5 mL
Tranmix 10 % x 10 tube 5 mL
Tranofast 500mg/5ml Injection (Knoll Pharmaceuticals Ltd)$ 0.14
TRANOFAST 500MG INJECTION 1 vial / 5 ML injection each (Knoll Pharmaceuticals Ltd)$ 0.72
TRANOMAC 500MG TABLET 1 strip / 6 tablets each (Macleods (Osteva))$ 1.23
TRANOMAC tab 500 mg x 6's (Macleods (Osteva))$ 1.29
Tranostat 500mg TAB / 10 (Ozone Pharmaceuticals Ltd.)$ 1.69
500 mg x 5 mL x 5's (Ozone Pharmaceuticals Ltd.)
Tranostat Inj 500 mg Injection (Ozone Pharmaceuticals Ltd.)$ 0.17
Tranostat 500 mg Tablet (Ozone Pharmaceuticals Ltd.)$ 0.17
TRANOSTAT 500 MG INJECTION 1 vial / 5 ML injection each (Ozone Pharmaceuticals Ltd.)$ 0.83
TRANOSTAT 500 MG TABLET 1 strip / 10 tablets each (Ozone Pharmaceuticals Ltd.)$ 1.95
TRANOSTAT inj 500 mg x 5 mL x 5ml (Ozone Pharmaceuticals Ltd.)$ 0.63
TRANOSTAT film-coated tab 500 mg x 10's (Ozone Pharmaceuticals Ltd.)$ 1.87

References

  1. DailyMed. "TRANEXAMIC ACID: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "tranexamic acid". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "tranexamic acid". http://www.drugbank.ca/drugs/DB00302 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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