Cyklokapron

tranexamic acid

(tran-ex-am-ikas -id) ,

Cyklokapron

(trade name),

Lysteda

(trade name) Pregnancy Category: B

Indications

Action

Pharmacokinetics

Time/action profile (blood levels)

ROUTE	ONSET	PEAK	DURATION
IV	unknown	unknown	7–8 hr
PO	unknown	2.5 hr	unknown

Contraindications/Precautions

Adverse Reactions/Side Effects

Central nervous system

• seizures (life-threatening)
• headache (most frequent)
• dizziness

Ear, Eye, Nose, Throat

• visual abnormalities

Cardiovascular

• hypotension
• thromboembolism
• thrombosis

Gastrointestinal

• diarrhea
• nausea
• vomiting

Musculoskeletal

• pain (most frequent)

Miscellaneous

PO:
• anaphylaxis (life-threatening)

Interactions

Drug-Drug interaction

Concurrent use of hormonal contraceptives may ↑ risk of thrombosis (PO); concurrent use contraindicated.Concurrent use of clotting factor complexes may ↑ the risk of thrombotic complications (give tranexamic acid 8 hr following clotting factor replacement therapy).May ↑ the procoagulant effects of all-trans retinoic acid.↓ effectiveness with thrombolytic agents.

Route/Dosage

Availability (generic available)

Nursing implications

Nursing assessment

• Prevention of post-surgical hemorrhage: Observe site of surgery for excessive bleeding.
• Heavy menstrual bleeding: Monitor menstrual flow prior to and during therapy.
• Patients taking tranexamic acid for more than several days should have ophthalmologic examinations to detect visual abnormalities prior to and at regular intervals during and after therapy. Discontinue therapy if visual changes occur.

Potential Nursing Diagnoses

Risk for injury (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

• Oral: Administer 3 times daily without regard to food. Swallow tablets whole; do not crush, break, or chew.

• Intravenous Administration

• Intermittent Infusion: Diluent: May be diluted with most solutions, such as electrolyte, carbohydrate, amino acid, and dextran solutions. Prepare mixture on day of infusion.
• Rate: Infuse at a rate not to exceed 100 mg (1 mL)/min. More rapid administration has resulted in hypotension.
• Y-Site Compatibility: heparin
• Y-Site Incompatibility: ampicillin, ampicillin/sulbactam, blood, penicillin, piperacillin/tazobactam, ticarcillin/clavulanate

Patient/Family Teaching

• Instruct patient to take medication as directed; do not take more than 6 tablets/day, for longer that 5 days in any menstrual cycle, or when not menstruating. Take missed doses as soon as remembered, then take next dose as least 6 hrs later; do not double doses. Advise patient to read Patient Information before starting and with each Rx refill in case of changes.
• Advise patient to stop medication and inform health care professional of any changes in vision. Inform patients on prolonged therapy of the importance of regular ophthalmologic follow-up.
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications. Caution patient to avoid taking hormonal contraceptives and products containing aspirin or NSAIDs without consulting health care professional.
• Instruct patient to notify health care professional if signs and symptoms of thrombosis (severe, sudden headache; pains in chest, groin, or legs, especially calves; sudden loss of coordination; sudden and unexplained shortness of breath; slurred speech; visual changes; weakness or numbness in arm or leg) or anaphylaxis (shortness of breath, throat tightness, rash) occur.
• Instruct patient to notify health care professional if heavy menstrual bleeding persists or worsens or if bleeding does not lessen after 2 cycles or tranexamic acid seems to stop working.

Evaluation/Desired Outcomes

• Prevention of hemorrhage during and following dental surgery in hemophiliacs.
• Reduced menstrual blood loss.