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Title: TXA Quick Review (submitted by Kortney Morrell, PharmD)

Category: Pharmacology & Therapeutics

Keywords: bleeding, epistaxis, tranexamic acid (PubMed Search)

Posted: 3/2/2019 by Ashley Martinelli (Updated: 7/21/2026)

Mechanism of Action	Tranexamic Acid (TXA) is an antifibrinolytic agent that is a competitive inhibitor of plasminogen activation, and a non-competitive inhibitor of plasmin Inhibits the breakdown of fibrin mesh allowing clot formation Vial Concentration: 1000mg/10 mL
When is it Indicated?	Epistaxis/Oral Bleeds/Fistula Bleeds Local application of injectable form of TXA Dose: Gauze soaked with 500 mg (5 mL) applied topically to the site of bleeding
When is it Indicated?	Trauma Criteria for use: Significant hemorrhage or significant risk of hemorrhage in adult trauma patients (SBP <90 mmHg and/or HR >110 bpm) Dose: 1g in 100 mL 0.9% NaCl infused over 10 minutes followed by 1g in 100 mL 0.9% NaCl over 8 hours
Adverse Reactions	Generally well tolerated GI Disturbances: nausea, vomiting, diarrhea Thrombotic Events Hypersensitivity reactions: anaphylaxis and anaphylactoid reactions Hypotension following rapid injection (maximum rate is 100 mg/minute)