Tranexamic Acid 1g in 90ml NSS Infusion Time
Tranexamic acid 1g in 90ml normal saline should be infused over 10 minutes (at a rate of approximately 10ml/minute). 1, 2
Standard Infusion Rate
The WHO strongly recommends administering tranexamic acid at a fixed dose of 1g (100mg/mL) intravenously at 1mL/min, which equals a 10-minute infusion time. 1
This 10-minute infusion protocol is consistently supported across multiple high-quality guidelines including European trauma guidelines 1, and represents the evidence-based standard from the landmark CRASH-2 trial. 3, 4
Your preparation of 1g in 90ml NSS should therefore run at approximately 9-10ml/minute to achieve the recommended 10-minute total infusion time. 1
Critical Timing Considerations
Administer as early as possible and within 3 hours of bleeding onset or injury. 1, 2
Effectiveness decreases by 10% for every 15-minute delay in administration. 1, 5, 2
Administration beyond 3 hours post-injury may increase risk of death due to bleeding and should be avoided. 1, 5, 2
Complete Dosing Protocol
After the initial 1g loading dose over 10 minutes, follow with a second 1g dose infused over 8 hours. 1, 2, 3
For post-partum hemorrhage specifically, a second 1g bolus (also over 10 minutes) should be given if bleeding continues after 30 minutes or restarts within 24 hours. 1
For trauma patients, the maintenance infusion of 1g over 8 hours should begin immediately after the loading dose. 1, 4
Common Pitfalls to Avoid
Never infuse the loading dose faster than 10 minutes - rapid bolus administration is not supported by evidence and may increase adverse effects. 1
Do not delay administration to "confirm" hyperfibrinolysis - TXA should be given to all patients with clinically significant bleeding regardless of laboratory confirmation. 1
Avoid administration in patients with active thromboembolic events during pregnancy or known contraindications to antifibrinolytic therapy. 1
Higher doses are associated with increased seizure risk, particularly exceeding 100mg/kg total dose. 5, 6