Tranexamic acid

CYKLOKAPRON

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Pronunciation: tran-ex-AM-ik AS-id

Tranexamic acid ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Tranexamic acid ballicule

Tranexamic acid CYKLOKAPRON mascot mnemonic cartoon — Visual mnemonic: Tranexamic acid mascot
**“Examine a Clog cap on”**

What it isAntifibrinolytic blocking plasminogen binding to fibrin; hemorrhage and heavy menstrual bleeding.

Why this oneGiven within three hours it reduces mortality in trauma and postpartum hemorrhage, at negligible cost.

What limits itAfter three hours it may increase mortality in trauma. Seizures at high dose; caution with thrombotic risk.

Tranexamic acid molecular structure (skeletal formula) — Molecular structure: Tranexamic acid

FDA-approved for

cyclic heavy menstrual bleeding (2009)
hemophilia dental extraction

Off-label

trauma and postpartum hemorrhage
melasma
epistaxis

Principal riskTiming: after three hours it may increase trauma mortality

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityThrombosis or serious bleeding from under- or overcorrection; agent-specific laboratory monitoring is often required.

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Medication errors from wrong route: IV use only—inadvertent neuraxial (intrathecal/epidural) administration has caused seizures, cardiac arrhythmias, and death.

FDA dosing	Population	Start	Target	Max
Hemophilia: reduce/prevent hemorrhage and need for replacement therapy during and after tooth extraction (short-term, 2–8 days)	Adults	10 mg/kg (actual body weight) IV once immediately before extraction, with replacement therapy	10 mg/kg IV TID–QID × 2–8 days after extraction	10 mg/kg QID

Renal Reduce all doses (before and after extraction) by SCr: 1.36–2.83 mg/dL: 10 mg/kg IV BID; 2.83–5.66: 10 mg/kg IV QD; >5.66: 10 mg/kg IV q48h or 5 mg/kg IV q24h.

Hepatic Undefined

Limited pediatric data suggest no significant PK differences from adults.

Instructions

IV only—never neuraxial; confirm route and label syringes 'IV'.
Undiluted (100 mg/mL): infuse ~0.5 mL/min, no faster than 1 mL/min (hypotension).
Diluted to 10 or 20 mg/mL: infuse at 5 or 2.5 mL/min respectively; diluted solution stable up to 4 h at room temp.
Do not mix with blood or penicillin-containing solutions; heparin may be added.

Available strengths

inj 100 mg/mL
tab 650 mg

Contraindications

Neuraxial (intrathecal, epidural) injection
Subarachnoid hemorrhage (cerebral edema and infarction)
Active intravascular clotting

Cautions

Medication errors from incorrect route
Thromboembolic risk (avoid Factor IX complex, anti-inhibitor coagulant concentrates, hormonal contraceptives)
Seizures
Hypersensitivity reactions
Visual disturbances
Dizziness

Adverse reactions

Nausea
Vomiting
Diarrhea
Allergic dermatitis
Giddiness
Hypotension (rapid IV injection)
Thromboembolic events

Pregnancy Crosses placenta (cord levels ≈ maternal); human data have not clarified risk; no adverse fetal effects in animal studies.

Lactation Present in human milk; no data on breastfed-infant effects or milk production; weigh benefits against maternal need.

Cost

Tranexamic acid (CYKLOKAPRON)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/unit	CostPlus
100 mg/mL	inj	per unit	$0.40/mL	not offered

Generic entry2011

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Self-check

Within what time does tranexamic acid reduce mortality in trauma and postpartum hemorrhage?
Three hours.
What can tranexamic acid do after three hours in trauma?
May increase mortality.