Tranexamic Acid Administration Route
Tranexamic acid (Tranexa) injection is administered intravenously (IV), not intramuscularly (IM). 1, 2
Route of Administration
Tranexamic acid injection is for intravenous use only and should never be administered via other routes including intramuscular or intrathecal injection 2
The FDA explicitly warns that serious adverse reactions including seizures and cardiac arrhythmias have occurred when tranexamic acid injection was inadvertently administered via incorrect routes 2
Syringes containing tranexamic acid injection should be clearly labeled with the intravenous route of administration to avoid medication errors 2
Standard IV Dosing Protocol
The recommended dose is 1 gram IV administered over 10 minutes (at 1 mL/min) 3, 4
A second dose of 1 gram may be given if bleeding continues after 30 minutes or restarts within 24 hours of the first dose 3, 4
For postpartum hemorrhage specifically, tranexamic acid must be administered within 3 hours of birth, as efficacy decreases by approximately 10% for every 15-minute delay 3, 4
No benefit is seen after 3 hours post-birth, and administration beyond this timeframe may be potentially harmful 3, 4
Important Safety Considerations
Confirm the correct IV route before administration to avoid confusion with other injectable solutions that might be administered simultaneously 2
Tranexamic acid is contraindicated in patients with active intravascular clotting or history of thromboembolic events during pregnancy 1, 4, 2
The drug may cause seizures, particularly at higher doses, and should be discontinued if seizures occur 2
Hypersensitivity reactions including anaphylaxis have been reported with IV tranexamic acid use 2
Research on Alternative Routes
While intramuscular administration has been studied in research settings with reported bioavailability of 105%, this route is not FDA-approved or recommended for clinical use 5
Intraarticular administration has been studied specifically for orthopedic surgery (TKA) but is not the standard route for systemic hemorrhage control 6
WHO guidelines specifically state that recommendations apply to intravenous administration only, as benefits and potential harms of other routes remain a research priority 1