Tranexamic Acid

Section 1.1

Midwives may independently prescribe, order and administer this drug.

Indications and Clinical Use:

Tranexamic acid is an effective agent for the treatment of postpartum uterine atony and/or for postpartum haemorrhage (PPH) when used in conjunction with other uterotonics. It may be ordered and administered by midwives based on its availability, the clinical scenario, and in accordance with local, provincial and national PPH treatment algorithms.

Contraindications:

Tranexamic acid is contraindicated in those with risk factors for thrombosis, active thromboembolic disease (i.e. deep vein thrombosis), haematuria, and/or sensitivity to tranexamic acid.

Warnings and Precautions:

Do not use to treat PPH that starts more than three hours after birth. Tranexamic acid must be stored at 15oC to 30oC.

Pregnancy:

Category B- Limited data

Lactation:

Category L3 – Limited Data – Probably Compatible

Adverse Reactions:

Nausea, vomiting, diarrhea, dizziness, visual disturbances, thromboembolism (rare), convulsions (rare).

Dosage and Administration:

First dose: 1g in 10mL electrolyte or carbohydrate solution (e.g. 0.9% NaCl, Ringer’s Lactate, DW5) (100mg/mL) IV at 1mL per minute once PPH identified, up to three hours after birth.

Second dose: 1g IV 30 minutes after the first dose if bleeding continues, or if bleeding restarts within 24 hours of completing first dose.

Onset of Action:

Rapid

Half-life:

2 hours

Elimination:

Renal