Table 1 Dose of TXA used for haemostatic and non-haemostatic indications

Haemostatic indications

Orthopaedic surgery

high dose IV TXA: ≥ 20 mg/kg or > 1 g and high dose topical TXA: > 1.5 g

[118, 119]

Cardiac surgery

50 mg/kg bolus

[36]

Trauma

IV 1 g bolus (± pre-hospital) then 1 g infusion over 8 h

[34, 49, 120]

Obstetric bleeding

IV 1 g bolus (± second bolus if ongoing/recurrent bleeding)

[37]

Dental bleeding in patients with a bleeding disorder

TXA mouthwash (50 mg/mL): 10 mL 4 times/day IV: 0.5–1 g 2–3 times/day Oral: 1–1.5 g 2–3 times/day

[121, 122]

Hereditary haemorrhagic telangiectasia

3 g in 24 h

[123]

Gastrointestinal bleeding

1 g over 1 h then 3 g over 24 h

[124]

Negative study

Intracerebral haemorrhage

1 g over 10 min then 1 g over 8 h

[52, 55, 125, 126]

Negative study

Malignant thrombocytopenia

1 g IV 8 hourly or 1.5 g orally 8 hourly

[127]

Negative study

Haemostatic indications under investigation

Reduce recurrent cerebral bleeding in chronic amyloid angiopathy

20 mg/mL for 6 months

[67]

Evaluated in mice overexpressing the mutant human amyloid precursor protein

Non-haemostatic indications

Hereditary angioedema

2–4 g in 24 h

[128]

Can be used therapeutically and as prophylaxis

Melasma

500–750 mg in 24 h

[112]

Non-haemostatic indications under Investigation

Reduce infection after gastrointestinal surgery

15 mg/kg bolus before surgical incision, then infusion at 5 mg/kg/h until the end of surgery

TRIGS Clinical Trial https://www.trigs.org.au/

Reduce delirium following gastrointestinal surgery

15 mg/kg bolus before surgical incision, then infusion at 5 mg/kg/h until the end of surgery

TRIGS-D Clinical Trial https://www.trigs.org.au/trigs_d

Reduce severity of necrotising deep tissue infection

2 g daily for 4 days

TRITON Clinical Trial https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382739&isReview=true