Tranexamic Acid (TXA)

Mechanism of action

Synthetic lysine analogue that blocks lysine-binding sites on plasminogen, preventing fibrin breakdown (antifibrinolytic).

Dosing

Adult

Trauma: 1 g IV over 10 minutes within 3 hours of injury, then 1 g IV over 8 hours. Postpartum hemorrhage: 1 g IV, repeat once if bleeding continues

Pediatric

Trauma: commonly 15 mg/kg (max 1 g) IV, then 2 mg/kg/h

Hemoptysis (off-label): e.g., 500 mg nebulized up to three times daily. Reduce IV dose in renal impairment.