From the FDA Drug Label
- DOSAGE & ADMINISTRATION 2.1 Recommended Dosage The recommended dose of tranexamic acid injection is 10 mg/kg actual body weight intravenously administered as a single dose, immediately before tooth extractions. The recommended dose of Tranexamic acid (TXA) for a 9kg child is 10 mg/kg, which would be 90 mg. 1
From the Research
For a 9kg child, the recommended dose of tranexamic acid (TXA) is 15mg/kg, which translates to a dose of 135mg, as this is the most common initial dosing used in pediatric trauma patients, as reported in the study by 2.
Recommended Dosing Regimen
The dosing regimen for TXA in pediatric patients can vary depending on the specific clinical context, but the study by 2 suggests that an initial dose of 15mg/kg is commonly used.
- The dose can be administered intravenously over 10 minutes.
- For trauma or surgical bleeding, this dose can be repeated every 6-8 hours as needed.
- If using TXA for antifibrinolytic purposes during surgery, the dose should be given just before the procedure begins.
Monitoring and Contraindications
When administering TXA, it is essential to monitor for potential side effects, including:
- Nausea
- Vomiting
- Diarrhea
- Hypotension TXA works by inhibiting plasminogen activation, which prevents the breakdown of fibrin clots and helps maintain hemostasis.
- This medication is contraindicated in patients with active thromboembolic disease, so ensure the child has no history of thrombosis before administration.
- Adjust dosing for renal impairment if applicable, as TXA is primarily excreted by the kidneys.
Clinical Context and Evidence
The use of TXA in pediatric trauma patients is supported by studies such as 2 and 3, which highlight the efficacy and safety of TXA in reducing bleeding and transfusion requirements in pediatric patients.
- However, it is crucial to consider the specific clinical context and the potential risks and benefits of TXA administration in each individual case.
- The study by 4 provides valuable insights into the pharmacokinetics of TXA in neonates and infants undergoing cardiac surgery, and suggests a dosing regimen of 10mg/kg as a bolus, followed by an infusion of 10mg/kg/h, to maintain therapeutic plasma concentrations.