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  • Hexakapron Injection
    / Teva


    Active Ingredient
    Tranexamic Acid 500 mg / 5 ml

    Status in Israel
    RX

    Presentation and Status in Health Basket

    Presentation Basket Yarpa Pharmasoft

    Ampoule

    10 X 5 ml

    partial basket chart 66993

    Ampoule

    25 X 5 ml

    partial basket chart 28959 8381

    Dosage

    Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
    Note: Intravenous administration is necessary only if it is difficult to give adequate doses orally.
    The blood levels of tranexamic acid are increased in patients with renal insufficiency. Therefore doses should be reduced in renal impairment.
    Rapid intravenous injection should be avoided.
    Adults: The recommended standard dosage is 5-10 ml intravenously, at a rate of 1 ml/minute, or 2-3 Hexakapron tablets, 2-3 times daily.
    For the indications listed below, specific recommendations are made as follows:
    General Fibrinolysis: 10 ml intravenously, 3-4 times daily.
    Prostatectomy: 5-10 ml by slow I.V. injection, every 8 hours (the first dose being administered during the operation), for the first 3 days following surgery. Thereafter, 2-3 Hexakapron tablets, 2-3 times daily, until macroscopic hematuria is no longer present.
    Dental Surgery: Factor VIII or IX concentrates and Hexakapron 10 mg/kg body weight should be administered intravenously immediately before surgery.
    Following surgery, Hexakrapon tablets 25 mg/kg body weight should be administered orally, 3-4 times daily, for 6-8 days. As a rule, it is not necessary to administer factor VIII or IX concentrates following surgery.
    Epistaxis: Hexakapron injection may be applied topically to the nasal mucosa, either using a spray or by soaking a gauze strip in the solution and then packing the nasal cavity.
    Conization of the Cervix 1.5 g (3 ampoules), 3 times a day, for 12-14 days postoperatively.
    Children: Dosage should be calculated according to body weight, either 25 mg/kg Hexakapron tablets, or 10 mg/kg Hexakapron injection, intravenously.


    Indications

    General fibrinolysis. This may occur in prostatic and pancreatic carcinoma following thoracic surgery and other major operative procedures, in obstetrical complications such as abruptio placentae and post-partum hemorrhage, in connection with thrombolytic therapy, and in initial and follow-up treatment following prostatectomy and bladder surgery (see Precautions).
    Prior to, and following, dental surgery in hemophiliacs.
    Epistaxis. Conization of the cervix.


    Contra-Indications

    – Known hypersensitivity to tranexamic acid or to any other ingredient of the preparation.
    – Patients with thromboembolic disease.
    – Patients with active intravascular clotting.
    – Severe renal failure because of risk of accumulation.
    – Patients with subarachnoid hemorrhage. Anecdotal experience indicates that cerebral edema  and cerebral infarction may be caused by tranexamic acid in such patients.
    – Patients with acquired defective color vision, since this prohibits measuring one endpoint that should be followed as a measure of toxicity.
    See prescribing information for full details.


    Special Precautions

    Hepatic, cardiac or renal insufficiency, massive hematuria from the upper urinary tract, thrombotic tendency, even if an anticoagulant is administered simultaneously. Discontinue if disturbances in color vision arise.
    See prescribing information for full details.


    Side Effects

    Nausea, vomiting, diarrhea, giddiness, hypotension when intravenous injection is too rapid.
    See prescribing information for full details.


    Drug interactions

    Tranexamic Acid/Anti-Inhibitor Coagulant Complex or Factor IX Complex: Although tranexamic acid is often used in conjunction with clotting factor replacement for the perisurgical management of hemophilic patients, concurrent use may increase the risk of thrombotic complications. Some hematologists recommend that administration of tranexamic acid be delayed for 8 hours following injection of either of the clotting factor complexes
    Tranexamic Acid/Oral Contraceptives, Estrogen-Containing, or Estrogens: Concurrent use with tranexamic acid may increase the potential for thrombus formation).
    Tranexamic Acid/Thrombolytic agents: The actions of tranexamic acid and of thrombolytic agents e.g, tissue-type plasminogen activator, streptokinase, or urokinase are mutually antagonistic; although controlled studies to demonstrate its efficacy have not been done in humans, tranexamic acid may be useful in treating severe hemorrhage caused by a thrombolytic agent.


    Pregnancy and Lactation

    Pregnancy: Safety of use of tranexamic acid in pregnancy has not been established.
    Breastfeeding: Tranexamic acid is secreted into the mother’s milk at a concentration of about one hundredth of the corresponding serum level. Therefore, caution should be exercised when administered to nursing mothers.


    Overdose

    There is no known case of overdose with tranexamic acid tablets and injection.
    Symptoms may be nausea, vomiting, orthostatic symptoms and/or hypotension.
    Maintain a high fluid intake to promote renal excretion. There is a risk of thrombosis in predisposed individuals. Anticoagulant treatment should be considered.


    Manufacturer
    Teva Pharmaceutical Industries Ltd, Israel
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