tranexamic acid

Research Excerpts

Overview

Tranexamic acid (TXA) is an antifibrinolytic agent associated with reduced blood loss and mortality in a wide range of procedures, including spine surgery, traumatic brain injury, and craniosynostosis.

Effects

Tranexamic acid (TXA) has a high clinical value for the treatment of bleeding due to fibrinolysis. It has a great amount of applications in Orthopaedics and Traumatology, especially in primary and revision knee and hip arthroplasties, spine surgery and trauma.

Tranexamic acid (TXA) has been proven to prevent thrombolysis and reduce bleeding and blood transfusion requirements in various surgical settings. It has been shown to reduce blood loss following transurethral resection of the prostate and open radical prostatectomy.

Actions

Tranexamic acid can increase the permeability locally by non-invasive methods such as microneedling which is less painful than microinjection. The drug does not increase the risk of thromboembolic complications such as deep vein thrombosis, pulmonary embolism, or myocardial infarction.

Treatment

Tranexamic acid treatment was associated with a significant decrease in serum IL-1β at six and 24 hours and IL-10 at 24 hours from start of shock compared to vehicle control. Treatment did not result in serious adverse events nor thrombotic complications.

Toxicity

Topical tranexamic acid was safe and effective in primary total hip arthroplasty, reducing the need for blood transfusion compared to that described in the literature in untreated patients. Unease regarding possible systemic adverse effects prevents widespread systemic use, but local use is gaining popularity.

Pharmacokinetics

The population pharmacokinetic model of tranexamic acid in haemorrhagic caesarean section was successfully established in our tiny sample of patients. Although serum concentratratrat was measured, there was no evidence of a significant effect on plasma levels.

Compound-Compound Interactions

The hemostatic effect of tranexamic acid (TXA) combined with carbazochrome sodium sulfonate (CSS) in total hip arthroplasty (THA) has not been determined. Microinjection alone or combined with low-power, low-density fractional CO2 laser in a sequential pattern are comparatively effective and safe for melasma treatment.

Bioavailability

The oral bioavailability of tranexamic acid, calculated from 24 h urinary excretion after oral and intravenous administration, was 34% of the dose. When embedded in a fibrin sealant, is much longer than when intravenously administered.

Dosage Studied

The area of greatest clinical variability was seen in dosing regimes for Tranexamic acid. Blood loss greater than 400 ml was less common in women who received the drug after vaginal birth or caesarean section in the dosage of 1 g or 0.5 g.