Tranexamic Acid Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Bleeding

For the treatment of cyclic heavy menstrual bleeding:
1,300 mg (two 650 mg tablets) orally three times a day (3,900 mg/day) for a maximum of 5 days during monthly menstruation.

For patients with hemophilia for short-term use (two to eight days) to reduce or prevent hemorrhage and reduce the need for replacement therapy during and following tooth extraction:
Immediately before dental extraction in patients with hemophilia, administer 10 mg per kg body weight intravenously. Following surgery, a dose of 10 mg per kg body weight intravenously three to four times daily, may be used for 2 to 8 days.

Usual Pediatric Dose for Bleeding

Tranexamic acid has had limited use in pediatric patients, principally in connection with tooth extraction. The limited data suggest that dosing instructions for adults can be used for pediatric patients needing therapy.

For patients with hemophilia for short-term use (two to eight days) to reduce or prevent hemorrhage and reduce the need for replacement therapy during and following tooth extraction:
Immediately before dental extraction: 10 mg per kg body weight intravenously
Following surgery: 10 mg per kg body weight intravenously three to four times daily, may be used for 2 to 8 days.

Surgery for congenital heart disease (to reduce perioperative blood loss and need for transfusions):
(not FDA approved, limited data available, dose not established, variable dosing regimens reported)
2 months to 15 years:
loading dose: 100 mg/kg intravenously, followed by 10 mg/kg/hour infusion (continued until ICU transport) and 100 mg/kg priming dose when bypass initiated;
or
loading dose: 10 mg/kg intravenously, priming dose: 10 mg/kg and 10 mg/kg after protamine.

Surgery for scoliosis (to reduce perioperative blood loss and need for transfusions):
(not FDA approved, limited data available, dose not established, variable dosing regimens reported)
8 to 18 years:
loading dose: 100 mg/kg intravenously, followed by infusion: 10 mg/kg/hour until skin closure
or
loading dose: 20 mg/kg intravenously, followed by 10 mg/kg/hour infusion
or
loading dose: 10 mg/kg intravenously and 1 mg/kg/hour infusion.

For the treatment of cyclic heavy menstrual bleeding (ages 12 to less than 18):
1,300 mg (two 650 mg tablets) orally three times a day (3,900 mg/day) for a maximum of 5 days during monthly menstruation.

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) orally 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) orally once a day for a maximum of 5 days during menstruation.
Serum creatinine above 5.7 mg/dL:
650 mg (one 650 mg tablet) orally once a day for a maximum of 5 days during menstruation.

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

Liver Dose Adjustments

No dose adjustment is needed in patients with hepatic impairment.

Dialysis

Data not available

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