Transamin (Tranexamic Acid) is often prescribed for excessive bleeding. It is an antifibrinolytic that competitively inhibits the activation of plasminogen to plasmin, a molecule responsible for the degradation of fibrin. Fibrin is the basic framework for the formation of a blood clot in hemostasis. It has roughly 8 times the antifibrinolytic activity of an older analogue, ε-aminoacaproic acid.
Therapeutic Uses of Transamin
Transamin is a synthetic derivative of the amino acid lysine. It exerts its antifibrinolytic effect through the reversible blockade of lysine binding sites on plasminogen molecules. It inhibits endometrial plasminogen activator and thus prevents fibrinolysis and the breakdown of clot. Side effects are uncommon. While prolonged treatment may heighten the risk of an increased thrombotic tendency, such as deep vein thrombosis, large scale studies reveal that the incidence of thrombosis in women treated by Transamin is no different from the spontaneous incidence of thrombosis in women.
Transamin is used as firstline nonhormonal treatment of dysfunctional uterine bleeding, and heavy bleeding associated with uterine fibroids.
In acquired angioedema types I and II and non-histaminergic angioedema, antifibrinolytics such as Transamin may be effective.
Transamin is used in cardiac surgery, e.g. coronary artery bypass surgery, to prevent excessive blood loss.
Transamin is used in orthopedic surgery to reduce bloodloss. It is of proven value in clearing the field of surgery and reducing per and postoperative blood loss. Drain and number of transfusion is reduced. However the hidden blood loss is not reduced. Still it is becoming an important tool in the anaesthetist’s arsenal. It is commonly used in joint replacement surgery.