Antifibrinolytic Pregnancy: Available data from published studies, case series and case reports in the second and third trimester and at delivery have not clarified whether there is a drug-associated risk of miscarriage or adverse maternal or foetal outcomes; there are cases of foetal structural abnormalities resulting in death of the newborn following administration at conception or in the first trimester, though confounded. Tranexamic acid crosses the placenta (cord blood concentration about 30 mg/L after an intravenous injection of 10 mg/kg, as high as maternal blood) and is present in human milk. Use requires an accurate individual risk-benefit evaluation; women of childbearing potential must use effective contraception during treatment (SPC section 4.6).

Tranexamic Acid (Burns Surgery)

Brand names: Cyklokapron, Cyclokapron

Tranexamic acid is an antifibrinolytic used around burns surgery, particularly tangential excision and grafting, to reduce intraoperative blood loss and transfusion requirements during these often haemorrhagic procedures.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Standard treatment of general fibrinolysis: 1 g tranexamic acid (1 ampoule of 10 mL or 2 ampoules of 5 mL) by slow intravenous injection, equivalent to 15 mg/kg body weight

Route: Slow intravenous injection at a maximum of 1 mL per minute - INTRAVENOUS USE ONLY; must not be administered intrathecally, epidurally, intraventricularly, intracerebrally or intramuscularly. It is strongly recommended that syringes containing tranexamic acid are clearly labelled with the intravenous route to reduce the risk of fatal medication errors

Frequency: Every 6 to 8 hours

SOURCE: UK SPC (eMC) for Tranexamic Acid 100 mg/ml Solution for Injection, section 4.2 (https://www.medicines.org.uk/emc/product/11894/smpc). The SPC contains NO burns-surgery-specific regimen - burns, burn excision and grafting are not named in the fetched sections, and there is no pre-incision loading dose or intra-operative infusion regimen of the kind used in surgical bleeding protocols. The dose above is the SPC's own 'Standard treatment of general fibrinolysis' regimen, which is the closest stated fit for surgical bleeding; the alternative stated regimen is 'Standard treatment of local fibrinolysis: 0.5 g (1 ampoule of 5 mL) to 1 g (1 ampoule of 10 mL or 2 ampoules of 5 mL) tranexamic acid by slow intravenous injection (= 1 mL/minute) two to three times daily'. Both are quoted verbatim; no infusion (mg/kg/hour) regimen appears in this SPC and none has been inferred - if a burns-unit protocol specifies a loading dose plus maintenance infusion, that must be sourced separately. No maximum daily dose and no treatment duration are stated in section 4.2. Section 4.4 cautions: convulsions have been reported, and in coronary artery bypass graft surgery most cases followed intravenous injection of high doses (at the recommended lower doses the incidence of post-operative seizures was the same as in untreated patients); attention should be paid to possible visual disturbances including visual impairment, blurred vision and impaired colour vision, discontinuing treatment if necessary, with regular ophthalmological examinations during continuous long-term use; in haematuria from the upper urinary tract there is a risk of urethral obstruction; risk factors for thromboembolic disease should be considered before use. Elderly: no reduction in dosage is necessary unless there is evidence of renal failure. Hepatic impairment: no dose adjustment is required. US CROSS-CHECK (openFDA, tranexamic acid injection, Avenacy Inc.) is for a different indication - tooth extraction in patients with haemophilia (10 mg/kg actual body weight intravenously immediately before extraction, then 10 mg/kg 3 to 4 times daily for 2 to 8 days, infusing no more than 1 mL/minute) - and was not used for the dose on this page.

Paediatric dose

Dose: 20 mg/kg/day/kg

Route: Slow intravenous injection at a maximum of 1 mL per minute - intravenous use only

Frequency: Per day (total daily dose)

Max: Not stated in source

THE FIGURE IS MILLIGRAMS PER KILOGRAM PER DAY, NOT PER DOSE. Exact SPC wording (section 4.2, Paediatric Population): 'In children from 1 year, for current approved indications as described in section 4.1, the dosage is in the region of 20 mg/kg/day. However, data on efficacy, posology and safety for these indications are limited.' The SPC gives no division of that daily dose into individual doses and no paediatric maximum. It adds that 'the efficacy, posology and safety of tranexamic acid in children undergoing cardiac surgery have not been fully established'. There is no paediatric burns-surgery regimen in this SPC and none has been inferred. Verify against a children's formulary before use.

Dose adjustments

Renal

Contraindicated in severe renal impairment because of the risk of accumulation. For mild to moderate renal impairment the dose should be reduced according to serum creatinine: 120 to 249 micromol/L (1.35 to 2.82 mg/10 mL) - 10 mg/kg body weight every 12 hours; 250 to 500 micromol/L (2.82 to 5.65 mg/10 mL) - 10 mg/kg body weight every 24 hours; above 500 micromol/L (above 5.65 mg/10 mL) - 5 mg/kg body weight every 24 hours. No dose adjustment is required in hepatic impairment.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Paediatric weight-based calculator

Patient weight (kg)

Verify in a children's formulary

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Acute venous or arterial thrombosis
Fibrinolytic conditions following consumption coagulopathy, except in those with predominant activation of the fibrinolytic system with acute severe bleeding
Severe renal impairment (risk of accumulation)
History of convulsions
Intrathecal, epidural, intraventricular injection and intracerebral application (risk of cerebral oedema, convulsions and death)

Side effects

Common: gastrointestinal disturbance - nausea, vomiting, diarrhoea
Common: allergic dermatitis; fixed drug eruption (frequency not known)
Uncommon: malaise with hypotension, with or without loss of consciousness, generally following too fast an intravenous injection
Frequency not known: hypersensitivity reactions including anaphylaxis
Frequency not known: convulsions, particularly in case of misuse (including inadvertent intrathecal administration, which has caused severe back, gluteal and lower limb pain, myoclonus, generalised seizures and cardiac arrhythmias)
Frequency not known: visual disturbances including impaired colour vision; arterial or venous thrombosis at any site; acute renal cortical necrosis

Interactions

Section 4.5 of the UK SPC was not retrieved in this bundle - verify the full interaction section
Prothrombotic medical products - avoid concomitant use, as this can further increase the risk of thromboembolic adverse reactions; these include Factor IX Complex concentrates, anti-inhibitor coagulant concentrates and hormonal contraceptives (US labelling)
Section 4.6 of the UK SPC states that women of childbearing potential have to use effective contraception during treatment, cross-referring to sections 4.4 and 4.5

Clinical monograph

How it works

It competitively blocks the lysine-binding sites on plasminogen, preventing its conversion to plasmin and stabilising formed fibrin clot, thereby reducing fibrinolysis and surgical bleeding.

Prescribing in practice

Assess thromboembolic risk before use, as inhibiting clot breakdown can predispose to venous or arterial thrombosis, and avoid in active thromboembolic disease.
Dose reduction is required in renal impairment because the drug is renally cleared and can accumulate.
It is used perioperatively as an adjunct to surgical haemostasis, not as a substitute for it.

Monitoring

Monitor blood loss, haemoglobin and for any clinical signs of thromboembolism, with renal function informing dosing.

Counselling the patient

This medicine helps reduce bleeding during burns surgery.
Report calf pain, swelling, chest pain or breathlessness, which could indicate a clot.
It is given around the time of the operation as part of blood-conservation care.

Evidence & guidelines

Tranexamic acid reduces surgical bleeding across many settings, supported by the CRASH-2 trial in trauma and increasing evidence in burns surgery.

Reference: CRASH-2 trial; BBA transfusion guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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