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
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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.
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Mechanism of
action
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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.
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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.
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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.
