Tranexamic acid (TXA)

1000mg/10ml ampoules (IV)

Executive Summary

(December 2022)

The antifibrinolytic agent tranexamic acid (TXA) is a synthetic lysin derivative that binds plasminogen and plasmin, blocking their interaction with fibrin (4). It is indicated extensively in the ED for a variety of bleeding scenarios. 


Adult dose for trauma with risk of significant hemorrhage (1)

1gr in 10 min + 1gr in 8 hrs IV.

Adult dose

Adult dose for trauma with risk of significant haemorrhage (1)

Patient selection

Best timing to administer TXA

About trauma-associated coagulopathy

From a physiopathological point of view, TXA should be administered when fibrinolytic activity is augmented, which can objectively be measured with viscoelastic assays like thromboelastography (TEG)(10). Interestingly, recent studies show that an early administration of TXA prevents development of a hyperfibrinolytic state which supports its usage not only in severely injured patients (7, 12, 13). 


Remarkable compendiums and analyses of the trial can be found at The Bottom Line and at The NNT



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