Medicines

Tranexamic acid for the treatment or prevention of bleeding in haemophilia and other clotting problems

This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Name of medicine

Tranexamic acid

Brand name: Cyklokapron®

This leaflet is about the use of tranexamic acid for:

  • The prevention or treatment of bleeding in children with haemophilia, von Willebrands’ disease or platelet problems.
  • The treatment of acute mouth or nose bleeds in children with von Willebrands’ disease or platelet problems.

Why is it important for my child to take tranexamic acid?

In haemophilia and other clotting problems, the blood does not clot as well as it should. Tranexamic acid helps to stop blood clots from breaking down, so it reduces bleeding. Your child may need to take tranexamic acid to prevent severe bleeding after certain procedures such as minor operations or having a tooth out, or to stop bleeding from the nose or mouth.  

What is tranexamic acid available as?

Tablets: 500 mg

Liquid medicine  can be ordered specially from your pharmacist

When should I give tranexamic acid

Tranexamic acid is usually given two or three times each day. Your doctor will tell you how often to give it.

Twice a day: this should be once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example some time between 7 and 8 am, and between 7 and 8 pm.

Three times each day: this should be once in the morning, once in the early afternoon and once in the evening. Ideally, these times are at least 6 hours apart, for example 8 am, 2 pm and 8 pm.

Give the medicine at about the same times each day so that this becomes part of your child’s daily routine, which will help you to remember.

Your doctor will tell you how long to give the medicine for. If it is to prevent severe bleeding after an operation or to treat bleeding from the mouth or nose, you can usually stop giving tranexamic acid when the bleeding has stopped.

If your child has heavy bleeding or still has bleeding 8 days after having an operation or dental treatment, contact your doctor.

How much should I give?

Your doctor will work out the amount of tranexamic acid (the dose) that is right for your child. The dose will be shown on the medicine label.

It is important that you follow your doctor’s instructions about how much to give.

How should I give tranexamic acid?

Tablets

Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablets. You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey or jam. Make sure your child swallows it all straight away.

Liquid medicine

Make sure your child takes it all straight away.

Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

When should the medicine start working?

The medicine should start working straight away and it should reduce your child’s bleeding on the first day.

What if my child is sick (vomits)?

If your child is sick less than 30 minutes after having a dose of tranexamic acid, give them the same dose again.

If your child is sick more than 30 minutes after having a dose of tranexamic acid, you do not need to give them another dose. Wait until the next normal dose.

What if I forget to give it?

If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7 am, you can give the missed dose any time up to 11 am. If you remember after that time, do not give the missed dose. Just give the next dose as usual.

If you usually give it three times a day: Do not give the missed dose. Just give the next dose as usual.

Never give a double dose of tranexamic acid.

What if I give too much?

You are unlikely to do harm if you give an extra dose of tranexamic acid by mistake but your child is more likely to have side-effects.

If you are concerned that you may have given too much, contact your doctor or NHS Direct (111 in England and Scotland, 111 or 0845 4647 in parts of Wales). Have the medicine or packaging with you if you telephone for advice.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Tranexamic acid sometimes causes serious side-effects. These are not likely to happen and the benefit of taking the medicine is greater than the risk of these effects. 

Side effects you must do something about

There is a very small risk that tranexamic acid may cause a clot in another part of the body. If any of the following happen, take your child to hospital or call an ambulance straight away:

  • Your child suddenly becomes short of breath or has severe pain in their chest.
  • Your child suddenly becomes confused, has slurred speech, becomes clumsy, has a severe headache or becomes weak, with numbness on one side of their body.
  • Your child suddenly loses their ability to see with one or both eyes.
  • Your child gets swelling, redness and pain in their foot or leg.

If your child has problems with seeing colours, contact your doctor straight away. The medicine may need to be stopped.

Other side-effects you need to know about

  • Your child may feel sick (nausea) or be sick (vomit). Giving the medicine with some food may help. They may also get diarrhoea. If you are worried talk to your doctor as they may want to reduce the dose.

  • Your child may develop itchiness or a mild skin rash – try applying a moisturising cream or itch relief cream. If this doesn’t help, contact your doctor, in case your child is allergic to tranexamic acid.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at www.mhra.gov.uk/yellowcard

Can other medicines be given at the same time as tranexamic acid?

  • You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

tranexamic acid should not be taken with some medicines that you get on prescription. It is important to tell your doctor and pharmacist about any other medicines your child is taking before starting tranexamic acid.

  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Tell your doctor if your daughter is using the oral contraceptive pill as this may increase the risk of blood clots if they take tranexamic acid as well. They can then discuss other risks for blood clots with you.

Is there anything else I need to know about this medicine?

If your child still has bleeding after 8 days contact your doctor. Do not change the dose of tranexamic acid without talking to your doctor first.

Your child will take tranexamic acid by mouth (orally) for up to 8 days after a procedure or surgery.

In some children, tranexamic acid may be taken regularly to prevent frequent nose bleeds. 

General advice about medicines

  • Try to give medicines at about the same times each day, to help you remember.
  • If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
  • Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
  • Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

Where should I keep this medicine?

  • Keep the medicine in a cupboard, away from heat and direct sunlight.
  • It does not need to be kept in the fridge.
  • Make sure that children cannot see or reach the medicine.
  • Keep the medicine in the container it came in.

Who to contact for more information?

Your doctor, pharmacist or nurse will be able to give you more information about tranexamic acid and about other medicines used to treat bleeding.

England: NHS 111

Tel 111

www.nhs.uk

Scotland: NHS 24

Northern Ireland: NI Direct

Wales: NHS Direct

Tel 111 (free) or 0845 46 47 (2p per minute)

111.wales.nhs.uk/

The Haemophilia Society

020 7939 0780

haemophilia.org.uk/

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review by November 2015.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.