Tranexamic Acid Injectable: Dosing and Precautions
Tranexamic acid guidance for postpartum haemorrhage, abnormal uterine bleeding, and trauma-associated haemorrhage.
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Source reviewed
September 2023
Guide category
Injectable drugs
Safety boundary
Prescription medicine information for clinician-guided use.
Kenza Health Hub presents this medicine page as structured health education. Check dose, route, interactions, pregnancy or breast-feeding considerations, and local protocol with a qualified clinician or pharmacist. Read our medical editorial policy.
Therapeutic action
Antifibrinolytic.
Indications
- Postpartum haemorrhage.
- Heavy abnormal uterine bleeding unrelated to pregnancy.
- Trauma-associated haemorrhage.
Forms and strengths, route of administration
- 500 mg in 5 ml ampoule (100 mg/ml) for slow IV injection or infusion in 0.9% sodium chloride or 5% glucose.
- Do not administer by IM route.
Dose and duration
Postpartum haemorrhage
Administer the dose over 15 minutes, in the first litre used for fluid resuscitation or in a bag of 100 ml of 0.9% sodium chloride, within 3 hours of delivery.
- Adolescent under 15 years: 15 mg/kg, maximum 1 g.
- Adult: 1 g.
- If haemorrhage persists 15 minutes after the end of the first dose or restarts within 24 hours, administer a second dose in 100 ml of 0.9% sodium chloride over 15 minutes. Maximum total dose 2 g.
Heavy abnormal uterine bleeding unrelated to pregnancy
- Adolescent and adult: 10 mg/kg every 8 hours until bleeding is reduced, maximum 600 mg per dose, then change to oral route.
Trauma-associated haemorrhage
Administer the dose over 10 minutes, in 5 ml/kg of 0.9% sodium chloride in children under 20 kg and in 100 ml of 0.9% sodium chloride in children 20 kg and over and adults, within 3 hours of injury. Then administer a second dose by continuous IV infusion over 8 hours.
- Child: 15 mg/kg, maximum 1 g.
- Adult: 1 g.
Contra-indications, adverse effects, precautions
- Do not administer to patients with current or past venous or arterial thromboembolic disorders, severe renal impairment, or history of seizures.
- Reduce dosage in patients with mild to moderate renal impairment.
- May cause gastrointestinal disturbances, hypotension and malaise if injected rapidly, seizures with high doses, visual disturbances, and allergic reactions.
- Avoid combination with drugs that increase the risk of thromboembolism such as oestrogens.
- Pregnancy: this drug is not indicated in the event of bleeding during pregnancy.
- Breast-feeding: no contra-indication.
- Do not mix with benzylpenicillin.
- Tranexamic acid can also be administered undiluted or diluted in smaller volumes of 0.9% sodium chloride in case of fluid restriction, maximum 100 mg/minute or 1 ml/minute.
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
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