TREN Capsule

Treatment of haemorrhage, or threatened haemorrhage associated with excessive fibrinolysis. It is also used in the management of haemophiliacs undergoing dental extractions, and in the prophylaxis of hereditary angioedema.

Dosage and Administration

The usual adult dose is 4-6 capsules to be taken 2-3 times daily. The dosage should be adjusted according to patient’s age and symptoms.

1. Patients with a history or risk of thrombosis should not be given Tranexamic acid, unless at the same time it is possible to give treatment with anticoagulants.

2. The preparation should not be given to patients with acquired disturbances of color vision. If disturbances of color vision arise during the course of treatment, the administration of the preparation should be discontinued.

Anorexia, hypnosia, pruritus, erythema, skin rash, and heartburn. Gastrointestinal disturbances (nausea, vomiting, diarrhoea) may occur.

1. Concurrent use of oral contraceptives or estrogen-containing medication with tranexamic acid may increase the potential for thrombus formation.

2. Concurrent use of Factor Ⅸcomplex with tranexamic acid may increase risk of thrombotic complication in perisurgical management of hemophilic patients. Some hematologists recommended that tranexamic acid not to be administered within 8 hours of these clotting factors concentrate.

Tranexamic acid crosses the placenta. However, healthy infants have been born to women who received Tranexamic acid during pregnancy for the treatment of fibrinolytic bleeding or bleeding associated with abruptio placentae. (FDA Pregnancy Category B).

Tranexamic acid is distributed into breast milk; concentrations reach approximately 1% of the maternal plasma concentration. Therefore risk-benefit of the use of tranexamic acid in nursing mother should be considered.

1. Tranexamic acid should be given in reduced doses to patient with impaired renal function.

2. Tranexamic acid therapy is not indicated in hematuria caused by diseases of the renal parenchyma. Intravascular precipitation of fibrin frequently occurs in these conditions and may aggravate the disease.

3. The risk of clotting may be increased in those with underlying thrombotic states.

Tranexamic acid produces an antifibrinolytic effect by competitively inhibiting the activation of plasminogen to plasmin. It is also a weak noncompetitive inhibitor of plasmin. These properties make possible its clinical use as an antifibrinolytic in the treatment of both general and local fibrinolytic haemorrhages. It has an action mechanism similar to, but about 10 times more patient in vitro than that of epsilon aminocaproic acid.