Specifications
1. Blood System Agents
2.Treatment for Hemostatics
3.Purity >*9%
4.Freely
soluble in water and in glacial acetic acid
5.Pharmaceutical grade
Brief Descriptions
Tranexamic acid (TXA) is an antifibrinolytic drug which is used to
control bleeding by preventing clot breakdown. TXA is a synthetic
derivative of the amino acid lysine that exerts its
antifibrinolytic effect through the reversible blockade of lysine
binding sites on plasminogen molecules.
Since its introduction into clinical practice over *0 years ago,
TXA has been used for a wide variety of clinical conditions where
there is haemorrhage or a risk of haemorrhage in increased
fibrinolysis and fibrinogenolysis. The use of the drug is made more
attractive in many patients by its ability to inhibit fibrinolysis
while having no apparent effect on blood clotting
parameters.
Mechanism of
action
In the haemostatic process, coagulation occurs rapidly at the site
of a damaged vessel building a tight net of fibrin, while at the
same time the fibrinolytic system removes the fibrin deposits that
could cause permanent vascular occlusion once vascular repair has
taken place. The coagulation and fibrinolytic system are believed
to be in a state of dynamic balance which maintains an intact
vascular system. Tranexamic acid is a potent antifibrinolytic agent
that exerts its effect by blocking lysine binding sites on
plasminogen molecules and has the potential to enhance the
effectiveness of the patients own haemostatic mechanisms.
Consequently, clot breakdown (fibrinolysis) is suppressed and
excessive or recurrent bleeding is reduced.
Applications
Tranexamic acid is frequently used in surgeries with high risk of
blood loss such as cardiac, liver, vascular and large orthopedic
procedures. Its oral form is now being evaluated for use in
outpatient conditions involving heavy bleeding.
Trauma
Tranexamic acid has been found to decrease the risk of death in
people who have significant bleeding due to trauma. However, it may
actually increase the
risk of death due to bleeding if administered more than 3 hours
after the injury.
Heart surgery
Tranexamic acid is commonly used in cardiac surgery, both with and
without cardiopulmonary bypass. It replaces aprotinin.
Orthopedic surgery
Tranexamic acid is used in orthopedic surgery to reduce bloodloss.
It is of proven value in clearing the field of surgery and reducing
pre- and postoperative blood loss. Drain and number of transfusions
are reduced. However, the hidden blood loss is not reduced. Still,
it is becoming an important tool in the anaesthetist's arsenal. It
is commonly used in joint replacement surgery.
Dentistry
Tranexamic acid is used in dentistry in the form of a 5% mouth
rinse after extractions or surgery in patients with prolonged
bleeding time, e.g. from acquired or inherited
disorders.
Menstrual bleeding
Used as firstline nonhormonal treatment of dysfunctional uterine
bleeding, and heavy bleeding associated with uterine fibroids. A
recent study showed patients treated with tranexamic acid are more
likely to develop thrombosis and necrosis in their fibroids, and
may result in pain and fever.
Dosage
The dose regimens of TXA vary widely. Studies examining the impact
of different doses of TXA on bleeding and transfusion requirements
showed no significant difference between a high dose and a low
dose. Studies in cardiac surgery have shown that a *0 mg/kg initial
dose of TXA followed by an infusion of 1 mg/kg/hour produces plasma
concentrations sufficient to inhibit fibrinolysis in vitro. The
CRASH*2 trial used a dose of 2 grams with no increase in
complications compared to placebo. Trials of the use of TXA in
obstetric haemorrhage used TXA at a dose of 1 gram without major
complications.
