Simtrax

Generic composition: Tranexamic acid

General Introduction
Tranexamic acid is an anti-fibrinolytics drug used in case of severe hemorrhage.

Therapeutic category

• Anti-fibrinolytics

Dosage forms available

• SIMTRAX 500mg Tablets

Mechanism of action
Tranexamic acid competitively inhibits activation of plasminogen (via binding to the kringle domain), thereby reducing conversion of plasminogen to plasmin (fibrinolysin), an enzyme that degrades fibrin clots, fibrinogen, and other plasma proteins, including the procoagulant factors V and VIII. Tranexamic acid also directly inhibits plasmin activity, but higher doses are required than are needed to reduce plasmin formation

Pharmacokinetics

• Absorption: Approximately 30 to 50% of the ingested dose is absorbed; bioavailability is not affected by food intake and is approximately 45%, 3% bound to plasma proteins
• Distribution: 9 to 12 L
• Metabolism: small fraction of the tranexamic acid is metabolized (less than 5%)
• Elimination: eliminated by urinary excretion primarily via glomerular filtration with more than 95% of the dose excreted unchanged
• Half-life: biological half-life is about 3 hours 

Indications

• Menorrhagia
• Tooth extraction
• Traumatic Injury
• Epistaxis and tonsillectomy
• Prostatic surgery
• Cardio-pulmonary bypass surgery

Dose

• 2 tablets to be taken three times daily, up to 5 days.
• Not indicated for pediatric and geriatric use.

Side effects

Common side effects include headache, sinus and nasal symptoms, back pain, abdominal pain, musculoskeletal pain, joint pain, muscle cramps, migraine, anemia, fatigue, allergic skin reactions, visual disturbances, dizziness, 

 Thromboembolic events (e.g., deep vein thrombosis, pulmonary embolism, cerebral thrombosis, acute renal cortical necrosis, and central retinal artery and vein obstruction); cases have been associated with concomitant use of combination hormonal contraceptives, impaired color vision and other 

Contraindication

• Hypersensitivity to Tranexamic acid.
• Thromboembolic risk

Pregnancy category: Category B

Precautions

• Ocular effects
• Severe allergic reactions
• Renal impairment
• Pregnancy and lactation

Drug Interaction

• Hormonal Contraceptives (may further exacerbate the increased thrombotic risk)
• Tissue Plasminogen Activators like: Alteplase, reteplase (decrease the efficacy of both)
• Anti-inhibitor Coagulant Concentrates (increased risk of thrombosis)