MASSACHUSETTS GENERAL HOSPITAL for CHILDREN
Department of Pharmacy
Department of Nursing
Neonatal/Pediatric Critical Care

Generic Name    

Tranexamic acid

Trade Name

Cyklokapron®

Designated Clinical Areas

Pediatric Critical Care, Pediatric Anesthesia

Action

• Antifibrinolytic agent that forms a reversible complex which displaces plasminogen from fibrin resulting in inhibition of fibrinolysis
• Inhibits the proteolytic activity of plasmin

Indication

• Reduce blood loss in cardiac surgery patients; mitigate effects of cardiopulmonary bypass

Critical Elements/Special Considerations

• May be administered by direct I.V. injection at a maximum rate of 100 mg/minute
• Incompatible with solutions containing penicillin
• Dosage modification required in patients with renal impairment
• Should not be administered concomitantly with factor IX complex concentrates or anti-inhibitor coagulant concentrates due to increased risk of thrombosis
• Contraindicated in patients with active intravascular clotting process

Administration Guidelines

Usual dose and route

0-20 kg

Dose: 10-25 mg/kg/hr

Bolus 100 mg/kg over 20 minutes

> 20 kg

Dose: 16-25 mg/kg/hr

Bolus: 30mg/kg over 20 minutes

Standard Concentration

100 mg/mL 50mL Syringe

Precaution and Side Effects

• Hypotension (with rapid I.V. administration), thromboembolic events (eg, deep vein thrombosis, pulmonary embolism, acute cortical necrosis)
• Cerebral ischemia and infarction (when used in the treatment of subarachnoid hemorrhage), headache, hydrocephalus, giddiness
• Thrombocytopenia, coagulation defects, abnormal bleeding times

Approved by:
PICU Collaborative Practice 3/10
MESAC 3/10