Tranexamic Acid

Provider Level

AEMT/RN/Paramedic

Class

Antifibrinolytic agent

Mechanism of Action

Competitively inhibits the activation of plasminogen to plasmin, thereby preventing the degradation of fibrin clots and promoting hemostasis.

Indications

Severe traumatic hemorrhage or suspected massive hemorrhage. Postpartum hemorrhage.

Contraindications

Time since injury greater than 3 hours. Active intravascular clotting. Known hypersensitivity.

Routes

IV, IO

Onset / Duration

Onset: Immediate. Duration: Approximately 3 hours.

Adverse Effects

Hypotension if administered too rapidly. Seizures. Deep vein thrombosis. Pulmonary embolism. Nausea and vomiting.

Precautions & Interactions

Administer slowly over 10 minutes to prevent hypotension. Do not administer in the same line as blood products.

Special Considerations

Administration is highly time-sensitive; greatest benefit is seen when given within the first hour of injury. Has been shown to increase mortality if administered greater than 3 hours post-injury.