Tranexamic acid


  • Action: Antifibrinolytic agent
  • Availability:
    • Ampule of 1 Gm in 10 mL


Severely bleeding trauma patient, systolic blood pressure of <90 and/or heart rate > 110 beats/min., with expected requirement for massive transfusion.

Contraindication/Exclusion Criteria

  • Greater than 3 hours from injury
  • Known sensitivity to TXA
  • Previous DVT or Pulmonary Embolism


  • Adult dose- Total of 2 Gms
    • Initial bolus of 1 Gm over 10 minutes (Slow IV push). Draw up with filter needle.
    • Maintenance: additional 1 Gm over next 8 hours (mix in 50 mL of NS). Call Pharmacy to mix and deliver the continuous infusion.
  • Pediatric dose- (weight based)
    • Initial bolus of 20 mg/kg IV Bolus over 10 minutes
    • Maintenance: 10 mL/kg/hr over next 8 hours

No additional laboratory tests required.

Adverse Reactions

  • Thrombotic events
  • Hypotension with rapid injection
  • Nausea, vomiting, diarrhea
  • Impaired color vision and other visual disturbances


Harbor-UCLA Tranexamic Acid (TXA) Guidelines for Administration in Trauma [{Category:Trauma]]