Trexam 250 mg/5 ml Injection

Antifibrinolytic (reduces bleeding by stabilising blood clots) for:

• Heavy menstrual bleeding
• Nosebleeds, bleeding after dental extraction (especially in haemophilia)
• Bleeding during and after surgery (cardiac, orthopaedic, prostate, gynaecological)
• Trauma with significant bleeding (within 3 hours) and postpartum haemorrhage (injection)
• Hereditary angioedema prevention
• Melasma (off-label, oral low dose on dermatologist advice)

Heavy periods (adults): 1–1.5 g (2–3 × 500 mg tablets) three times daily for up to 4–5 days during the period, starting when bleeding begins.

Local fibrinolysis / dental bleeding: 1–1.5 g two to three times daily.

IV (hospital): 0.5–1 g by slow injection, two to three times daily; trauma 1 g over 10 minutes then 1 g over 8 hours; postpartum haemorrhage 1 g IV, repeated once if needed.

Children: 25 mg/kg (oral) two to three times daily.

Kidney impairment: reduce dose.

• Active blood clots (deep vein thrombosis, pulmonary embolism, stroke) or history of thromboembolism (relative)
• Subarachnoid haemorrhage
• Severe kidney impairment
• History of seizures (IV)
• Disseminated intravascular coagulation (except specialist use)
• Blood in the urine from the upper urinary tract (risk of clots blocking the ureter)

Common: nausea, vomiting, diarrhoea, headache, back/abdominal pain (with periods), muscle cramps.

Less common: dizziness, allergic skin reactions, visual disturbance (stop and get an eye exam).

Rare but serious: blood clots (DVT, pulmonary embolism, stroke), seizures (high IV doses), low blood pressure with fast IV injection.

• Combined hormonal contraceptives, smoking, obesity: increased clot risk.
• Irregular periods or bleeding between periods need medical review before treatment.
• Long-term use: regular eye examinations.

Used in obstetric haemorrhage; otherwise use in pregnancy only if needed. Passes into milk in small amounts — compatible with breastfeeding.

• Combined oral contraceptives, oestrogens (increased clot risk)
• Factor IX complex, anti-inhibitor coagulant complexes, tretinoin (all-trans retinoic acid) (clot risk)
• Thrombolytics (opposite effect)

Dizziness, headache, nausea, vomiting, low blood pressure, seizures; risk of clots. Seek medical care.

Store below 30°C.