Tranamic

Management of painful bleeding. Short-term treatment for hemorrhage or risk of hemorrhage in conditions associated w/ increased fibrinolysis or fibrinogenolysis. Management of local fibrinolysis in prostatectomy & bladder surgery, menorrhagia, epistaxis, conization of the cervix, traumatic hyphaema, hereditary angioneurotic edema, & dental extraction in hemophiliacs. Mefenamic acid: Relief of mild to moderate pain in acute & chronic conditions including pain of traumatic, arthritic or muscular origin, primary dysmenorrhoea, headache & dental pain. Antipyretic in febrile conditions. Reduces blood loss in menorrhagia due to ovulatory dysfunctional bleeding.

Adult 1-1.5 g or 15-25 mg/kg bid-qid.

Tranexamic acid: Acquired defective colour vision. Subarachnoid haemorrhage. Active intravascular clotting. Mefenamic acid: Hypersensitivity. Not to be given to patients who have experienced asthma, urticaria or allergy-type reactions after taking ASA or other NSAIDs. Active ulceration or chronic inflammation of either the upper or lower GIT. Epileptics. Renal disease w/ impaired renal or hepatic function. Safety in pregnancy & lactation has not yet been established.

Discontinue use if clinical signs & symptoms consistent w/ liver or renal disease develop, systemic manifestations (eg, eosinophilia, rash) occur, or abnormal liver test persists or worsens. Reports of ureteral obstruction in patients w/ upper resp tract bleeding; venous & arterial thrombosis or thromboembolism. Perform ophth exam (including visual acuity, colour vision, eye-ground & visual fields) before commencing & at regular intervals during treatment in patients treated continually longer than several days; discontinue use if changes in exam results are found. Strictly supervise patients w/ disseminated intravascular coagulation during treatment. Periodically check CBC & chemistry profile in long-term treatment. Not to be administered concomitantly w/ factor IX complex conc or anti-inhibitor coagulant concentrates. Reduce dose in patients w/ renal insufficiency. Use during pregnancy only if clearly needed. Avoid use in late pregnancy due to risk of premature closure of ductus arteriosus. Caution in nursing woman. Elderly. Mefenamic acid: Anaphylactoid reactions may occur in patients w/o known prior exposure. Not to be given to patients w/ aspirin triad; aspirin-sensitive asthma. Not a substitute for corticosteroids or treatment of corticosteroid insufficiency. Use w/ caution in patients w/ preexisting asthma. Risk of GI ulceration, bleeding & perforation; anemia. May diminish diagnostic signs for complications of presumed non-infectious, painful conditions. Fluid retention & edema. Rehydrate patients w/ dehydration prior to therapy. Carefully monitor patients who may be adversely affected by alterations in platelet function (eg, those w/ coagulation disorders or receiving anticoagulants). Not recommended in preexisting advanced kidney disease. Borderline elevations of ≥1 LFTs may occur. Rarely, reports of severe hepatic reactions, including jaundice & fatal fulminant hepatitis, liver necrosis & hepatic failure, some w/ fatal outcomes. Renal papillary necrosis & other renal medullary changes in long-term use. Renal toxicity in patients in whom renal prostaglandins have a compensatory role in maintenance of renal perfusion. Safety & efficacy have not established in ped patients <14 yr.

Nausea, vomiting, diarrhea; dizziness, tininitus, headache; skin rash. Tranexamic acid: Cramps; transient disturbance in colour vision; malaise, weakness, fatigue, elevated serum enzymes eg, creatinine phosphokinase, rhabdomyolysis associated w/ myoglobinuria & renal failure; delirium, auditory, visual & kinesthetic hallucinations; conjunctival suffusion, nasal stuffiness, reversible acute renal failure, thrombophlebitis. Mefenamic acid: Abdominal pain, constipation, dyspepsia, flatulence, gross bleeding/perforation, heartburn, gastric/duodenal ulcers, abnormal renal function, anemia, edema, elevated liver enzymes, increased bleeding time, pruritus.

Haemostatics / Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

B02AA02 - tranexamic acid ; Belongs to the class of amino acid antifibrinolytics. Used in the treatment of hemorrhage.
M01AG01 - mefenamic acid ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, fenamates.

Rx