Antifibrinolytic

Tranexamic Acid (ICU/Trauma/Surgical)

Brand names: Cyklokapron, Cyklo-f

Used in: Gastrointestinal Bleeding Head Injury Epistaxis (Nosebleed)

Tranexamic acid is an antifibrinolytic used to reduce bleeding — in major trauma haemorrhage, surgery, and heavy menstrual bleeding, among other indications.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Before Extraction: Administer 10 mg/kg actual body weight of tranexamic acid injection intravenously with replacement therapy. ( 2.1 ) After Extraction: Administer 10 mg/kg actual body weight 3 to 4 times daily for 2 to 8 days. Infuse no more than 1 mL/minute to avoid hypotension. ( 2.1 ) Reduce the dosage for patients with renal impairment. ( 2.2 , 8.6 ) 2.1 Recommended Dosage The recommended dose of tranexamic acid injection is 10 mg/kg actual body weight intravenously administered as a single-dose, immediately before tooth extractions. Infuse no more than 1 mL/minute to avoid hypotension [see Warnings and Precautions ( 5.1 )]. Following tooth extraction, tranexamic acid injection may be …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-03-15. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It blocks plasminogen binding to fibrin, inhibiting fibrinolysis and stabilising formed clots.

Prescribing in practice

In major traumatic haemorrhage it should be given EARLY — benefit falls with delay.
Use caution with active thromboembolic disease or high thrombotic risk; reduce the dose in renal impairment.
High intravenous doses or rapid infusion have been associated with seizures.

Monitoring

Clinical assessment of bleeding and thrombotic risk; renal function for dosing.

Counselling the patient

For heavy periods it is taken only during menstruation.
Report calf pain or swelling, or breathlessness (possible clot).

Evidence & guidelines

Reduces mortality from bleeding in major trauma when given early (CRASH-2) and reduces surgical and menstrual blood loss.

Reference: CRASH-2 Trial (Lancet 2010); WOMAN Trial (Lancet 2017); CRASH-3 Trial (Lancet 2019); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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