Tranexamic acid

Pregnancy & gynaecology-specific. Every dose row is source-referenced; verify against institutional protocols.

Tranexamic acidEMERGENCY KITAntifibrinolytic

Regimens checked: 2026-10-17. Each indication has its own preparation, limits and safety checks.

Tranexamic acid: indication-specific regimens
Indication	Dose	Route	Frequency	Duration / preparation	Maximum	Monitoring / cautions
PPH of any cause; first dose as soon as possible and WITHIN 3 h of birth WHO · Supersedes 2012 TXA recommendation; now folded into Consolidated PPH 2025 Recs 27/29checked	1 g IV over 10 min; repeat 1 g if bleeding continues after 30 min OR restarts within 24 h	IV only	One initial dose; at most one additional 1 g dose under those criteria	Acute PPH treatment, maximum 2 doses in this regimen · 100 mg/mL: 1 g = 10 mL. Give no faster than 1 mL/min, or dilute in compatible sodium chloride 0.9% and infuse over 10 min. Clearly label IV ONLY; never intrathecal Renal / hepatic: Renal clearance: assess renal function and seek dose advice with impairment; do not repeatedly dose without review	2 g total. The 24 h repeat rule does NOT permit a first dose after the 3 h window	Monitor Quantified blood loss, uterine tone, BP/pulse, perfusion and urine output; record every dose and time Persistent shock or bleeding needs source control and blood products in parallel; do not wait for all drug doses Contraindications / cautions Clear contraindication to antifibrinolysis, such as a known thromboembolic event during pregnancy; renal dysfunction needs dose review
Heavy uterine bleeding unrelated to pregnancy after assessment MSFchecked	1 g (two 500 mg tablets)	Oral	Three times daily; if necessary up to four times daily	During bleeding only; stop when bleeding stops, maximum 5 days per episode · Swallow the prescribed 500 mg tablets with water; confirm pregnancy exclusion when clinically relevant Renal / hepatic: Reduce dose with renal impairment	4 g/day and no more than 5 days per episode	Monitor Bleeding response, Hb/iron deficiency; investigate persistent or changed bleeding Contraindications / cautions Current or previous thromboembolic disease, severe renal impairment or seizure history Combined oestrogen use needs an individual thrombosis-risk assessment

Pregnancy safety

Used in obstetric haemorrhage per WHO; not prophylaxis

Lactation

Compatible

Adverse effects

Nausea/diarrhoea; thromboembolism theoretical risk

WHO · Supersedes 2012 TXA recommendation; now folded into Consolidated PPH 2025 Recs 27/29checkedIN REVIEW