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Pronunciation |
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(tran
eks AM ik AS
id) |
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U.S. Brand
Names |
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Cyklokapron® |
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Generic
Available |
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No |
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Pharmacological Index |
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Antihemophilic Agent |
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Use |
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Short-term use (2-8 days) in hemophilia patients during and following tooth
extraction to reduce or prevent hemorrhage, has also been used as an alternative
to aminocaproic acid for subarachnoid hemorrhage |
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Pregnancy Risk
Factor |
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B |
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Contraindications |
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Acquired defective color vision, active intravascular
clotting |
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Warnings/Precautions |
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Dosage modification required in patients with renal impairment; ophthalmic
exam before and during therapy required if patient is treated beyond several
days; caution in patients with cardiovascular, renal, or cerebrovascular
disease; when used for subarachnoid hemorrhage, ischemic complications may
occur |
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Adverse
Reactions |
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>10%: Gastrointestinal: Nausea, diarrhea, vomiting
1% to 10%:
Cardiovascular: Hypotension, thrombosis
Ocular: Blurred vision
<1%: Unusual menstrual discomfort |
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Drug
Interactions |
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Chlorpromazine (may increase cerebral vasospasm and
ischemia) |
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Stability |
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Incompatible with solutions containing
penicillin |
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Mechanism of
Action |
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Forms a reversible complex that displaces plasminogen from fibrin resulting
in inhibition of fibrinolysis; it also inhibits the proteolytic activity of
plasmin |
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Pharmacodynamics/Kinetics |
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Half-life: 2-10 hours
Elimination: Primarily as unchanged drug (>90%) in urine
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Usual Dosage |
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Children and Adults: I.V.: 10 mg/kg immediately before surgery, then 25
mg/kg/dose orally 3-4 times/day for 2-8 days
Oral: 25 mg/kg 3-4 times/day beginning 1 day prior to surgery
I.V.: 10 mg/kg 3-4 times/day in patients who are unable to take oral
Dosing adjustment/interval in renal impairment:
Clcr 50-80 mL/minute: Administer 50% of normal dose or 10 mg/kg
twice daily I.V. or 15 mg/kg twice daily orally
Clcr 10-50 mL/minute: Administer 25% of normal dose or 10
mg/kg/day I.V. or 15 mg/kg/day orally
Clcr <10 mL/minute: Administer 10% of normal dose or 10
mg/kg/dose every 48 hours I.V. or 15 mg/kg/dose every 48 hours orally
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Administration |
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May be given by direct I.V. injection at a maximum rate of 100 mg/minute;
compatible with dextrose, saline, and electrolyte solutions |
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Reference Range |
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5-10 mg/mL is required to decrease
fibrinolysis |
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Mental Health: Effects
on Mental Status |
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None reported |
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Mental Health:
Effects on Psychiatric
Treatment |
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None reported |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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Report any signs of bleeding or myopathy, changes in vision; GI upset usually
disappears when dose is reduced |
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Nursing
Implications |
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Dosage modification required in patients with renal
impairment |
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Dosage Forms |
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Injection: 100 mg/mL (10 mL)
Tablet: 500 mg |
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References |
|
Astedt B, "Clinical Pharmacology of Tranexamic Acid," Scand J
Gastroenterol Suppl, 1987, 137:22-5.
Royston D,
"Blood-Sparing Drugs: Aprotinin, Tranexamic Acid, and Epsilon-Aminocaproic Acid,"
Int Anesthesiol Clin, 1995, 33(1):155-79.
Seto AH and Dunlap DS, "Tranexamic Acid in Oncology," Ann
Pharmacother, 1996, 30(7-8):868-70.
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