Tranexamic Acid and its use in children with a bleeding disorder

Information for Parents/Patients/Carers/Families on Tranexamic acid, including dosage, usage and side effects.

This leaflet is for parents/carers/families of children with a bleeding disorder. It provides information on the medication tranexamic acid that your child has been prescribed.

What is Tranexamic acid?

Tranexamic acid, or TXA as it is commonly known, is an anti-fibrinolytic medicine.

This type of drug helps the blood to clot. It does this as it prevents the breakdown of a protein called fibrin, which is the main protein in a blood clot.

Why do I need this information?

The manufacturer’s leaflet that comes in the box of Tranexamic acid is often aimed at adults and may not include all the information relevant to children and young people. This leaflet has been written specifically about the use of Tranexamic Acid in children and young people.

Why has my child been prescribed Tranexamic acid?

Tranexamic acid has been prescribed for your child as we have identified that they are experiencing bleeding symptoms.

Tranexamic acid is often used to prevent excessive bleeding, this can include post surgical procedures and dental procedures.

It is also used to prevent excessive bleeding from the nose, gums and bleeding from trauma.

It can also be very useful for heavy periods.

What forms can I get Tranexamic acid in ?

Tranexamic Acid comes in different forms.

• Tablets 500mg/tablet.
• Oral suspension 100mg/ml (this has a very short shelf life once opened so often tablets are a better option)
• Intravenous solution 100mg/ml

How is Tranexamic acid taken?

Tranexamic acid may be given by mouth as a tablet or liquid solution, both the tablets and the liquid solution can also be used as a mouthwash, the tablets can be crushed in water to do this.

In some situations your doctor or nurse may ask you to apply Tranexamic acid liquid or a crushed tablet directly to the area that is bleeding (this may be described as a topical application). This is particularly helpful for gum bleeding, mouth bleeding, nose bleeding and any superficial cuts and grazes that are taking a while to stop bleeding.

Tablets may be swallowed whole or crushed and taken with yoghurt or jam/honey. Tablets taste quite bitter so your child may needs lots of encouragement to take them.

If given as an oral suspension (liquid that is swallowed) the dose needs to drawn up in a syringe or onto a spoon and then given to the child for them to swallow.

If using tablets as a mouthwash after a dental extraction or for gum bleeding, the tablet should be crushed in some water then swilled around the mouth over the site of bleeding before swallowing.

Tranexamic acid Intravenous solution may also be injected into a vein. This would only ever be given to your child this way this way by a nurse or a doctor.

What dose of tranexamic acid will my child have?

Tranexamic acid is prescribed at 25mg/kg maximum dose 1 gram (2 tablets).If tablets are prescribed the dose will usually be rounded down to the nearest half tablet to help with ease of dosing. Your child’s dose will change as they grow.

When should my Child take Tranexamic acid?

For bleeding episodes your child will usually be asked to take their dose three times a day for 5 – 7 days. Doses should be at least 6 hours apart so it is best to space them out for example 8 am, 2 pm and 8pm.

Tranexamic acid may take 24 hours to take full effect, so if your child is due surgery we will ask you to start the dose from the evening prior to the procedure. Often after a surgical procedure you will be asked to continue the dosing for up to 14 days, three times a day.

Side effects

Most children do not experience side effects with Tranexamic acid.

However like all medications there are risks and side effects.

More common side effects are:

• Feeling sick
• Diarrhoea
• Itchy skin

If your child experiences any of these symptoms then you should not give any further doses and speak to your Haemophilia team.

There are also some less common, but more serious side effects so if your child experiences visual disturbances or becomes short of breath then contact your Haemophilia team.

If you child has any of the following symptoms.

• a skin rash that may include itchy, red, swollen, blistered or peeling skin
• wheezing
• a tightness in your chest or throat
• is having trouble breathing or talking
• their mouth, face, lips, tongue or throat start swelling

They could be having a serious allergic reaction and may need immediate treatment in hospital.

When should my child not have Tranexamic acid?

Tranexamic Acid should be avoided if there is visible bleeding in the urine.

If your child is experiencing this then contact your Haemophilia team.

How to cope with side effects.

Diarrhoea: encourage your child to drink plenty of fluids to avoid dehydration.

Itchy skin: Apply a soothing cream such as a moisturiser or calamine.

What do I do if my child vomits after the dose?

If your child is sick less than 30 minutes after having a dose of Tranexamic Acid, give them the same dose again.

If your child is sick more than 30 minutes after having a dose of Tranexamic Acid, you do not need to give them another dose. Wait until the next scheduled dose.

What should I do if I forget to give a dose?

If you usually give it three times a day: Do not give the missed dose. Just give the next dose as usual.

Never give a double dose of Tranexamic Acid and only give Tranexamic acid to the child it is prescribed for.

Can my child take other medicines alongside Tranexamic acid?

Tranexamic acid is safe to be taken with most other medicines.

If you have any questions regarding this medication please contact the Haemophilia team.

Contacts/Further information

Jo Crowe Paediatric Haemophilia Clinical Nurse Specialist 01223 257039

Joe Fox Paediatric Haemophilia Specialist Nurse 01223 257039

References/ Sources of evidence

Turner, H (2020) Leeds Teaching hospital,’Patient leaflet on Tranexamic acid.’

NHS medicines, accessed (2023) ‘Tranexamic acid’ www.nhs.uk/medicines/tranexamic-acid (opens in a new tab)