Antifibrinolytic Pregnancy: B

Tranexamic Acid (Burns Surgery)

Brand names: Cyklokapron, Cyclokapron

Adult dose

Dose: 1 g IV over 10 min at induction; repeat 1 g over 8 hours; or 500 mg–1 g oral three times daily

Route: IV slow injection or oral

Frequency: two to three times daily

Max: 4 g/day

Burns surgery: reduces blood loss during excision and grafting; CRASH-2 protocol: 1 g over 10 min then 1 g over 8h within 3h of trauma

Dose: 10 mg/kg

Route: IV

Frequency: every 8 hours

Max: 1 g per dose

Concentration: 100 mg/mL injection mg/ml

Burns excision and major surgery: 10–15 mg/kg IV before incision; max 1 g per dose; oral available but IV preferred intraoperatively

Renal

Reduce dose if eGFR <30 ml/min; avoid or use minimal dose if eGFR <10 ml/min (accumulation and seizure risk)

Hepatic

No dose adjustment required

Paediatric weight-based calculator

Patient weight (kg)

Burns excision and major surgery: 10–15 mg/kg IV before incision; max 1 g per dose; oral available but IV preferred intraoperatively

CRASH-2 trial: 9.6% reduction in mortality in major trauma within 3h of injury — time-critical
Burns excision: TBSA >20% burns surgery involves major blood loss; TXA reduces transfusion requirements
Seizure risk: dose-dependent IV — mechanism via GABA receptor antagonism; high risk in renal impairment

Reference: BNFc; BNF 86; CRASH-2 trial; BBA transfusion guidelines. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

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