Pediatric Dosing of Tranexamic Acid

Intravenous Dosing by Clinical Scenario

• The recommended pediatric dose of tranexamic acid for trauma and surgery is 15 mg/kg as a loading dose followed by 2 mg/kg/hour as an infusion 1
• For menorrhagia in adolescents, the dose is 30-50 mg/kg/day divided into 2-3 doses, with a maximum daily dose of 3-4 g 2
• For severe menorrhagia cases requiring IV treatment, the dose is 15 mg/kg followed by 2 mg/kg/hour infusion 2

Dose Adjustments for Special Populations

• Recent thrombosis, atrial fibrillation, or known thrombophilia are relative contraindications for tranexamic acid 2
• For adolescents with renal impairment, dose adjustment and monitoring of renal function is necessary 2

Alternative Approaches When First-Line Therapy Unavailable

• For short-term prophylaxis in hereditary angioedema, tranexamic acid may be considered at a maximum dose of 15-25 mg/kg two to three times daily 4

Topical Application

• For topical application in gauze soaks, the concentration is 500 mg in 5 mL (100 mg/mL) 3