Intrax

Indications

In Medicine:
Used for both the prevention and treatment of conditions such as hemoptysis, gastrointestinal bleeding, hemorrhagic syndromes related to leukemia, cirrhosis, hemophilia, and thrombocytopenic purpura. It is also indicated for complications arising from thrombolytic therapy and blood transfusions.

In Surgery:
Serves as a preventive and antihemorrhagic treatment during various surgical procedures, particularly in pulmonary, cardiovascular, and abdominal surgeries, as well as in cases of post-operative and traumatic shock.

In Urology:
Recommended for the prevention and treatment of bleeding in prostatic, bladder, and kidney surgeries, as well as in cases of hematuria.

In Obstetrics:
Utilized for preventing and treating postpartum and puerperal hemorrhages, hemorrhagic metropathies, and functional menometrorrhagia. It also addresses idiopathic or IUD-induced menorrhagia, hyperfibrinolysis due to abruptio placentae or premature placental detachment, and complications during cervical conization.

In Otorhinolaryngology:
Effective in preventing and treating bleeding during tonsillectomies and other specialized surgeries, as well as in managing epistaxis.

In Stomatology:
Applied in the prevention and treatment of bleeding during maxillofacial surgeries and tooth extractions.

In Oncology (Supportive Therapy):
Aids in forming a fibrin capsule to restrict the growth of ovarian tumors, promotes regression of ascites due to cancer, and minimizes bleeding during surgical procedures.

Always consult a registered healthcare professional before using any medication.

Pharmacology

This preparation contains tranexamic acid (trans-4 aminomethyl-cyclohexanecarboxylic acid), a powerful antifibrinolytic agent. It has been shown to be ten times more effective than traditional hemostatics in both in vivo and in vitro settings. The primary mechanism of action involves inhibiting plasminogen activation by both external and internal activators, which is crucial for its antihemorrhagic properties.

Tranexamic acid has a very low acute toxicity profile, with almost negligible chronic toxicity. It is well absorbed orally, with effects noticeable within 15-30 minutes. The drug is primarily excreted through the kidneys, but more slowly compared to conventional hemostatics, leading to a longer-lasting effect. This allows for significantly lower doses to be administered over extended intervals without dropping to ineffective plasma levels.

At therapeutic doses, tranexamic acid does not disrupt clotting mechanisms, and prolonged use has not been linked to a risk of thrombophilia.

Dosage & Administration

Adults:

• Standard Dose: 500-1000 mg, three times daily.
• For Prophylaxis: Recommended daily doses of 0.5-1 gm orally or 500 mg via intravenous or intramuscular routes.
• For Hemorrhagic Treatment: Oral doses can range from 1-3 gm in divided doses. In urgent cases, begin with a slow intravenous injection of 500 mg, followed by necessary oral doses.

Children:

• For Prophylaxis: Administer 5-10 mg per kg of body weight daily in divided doses.
• For Treatment: Double the oral dose (10-20 mg/kg). Initiate intravenous or intramuscular treatment at 10 mg/kg (0.5 ml per 5 kg) via slow IV route, while continuing oral doses. Ampoules can be diluted in sweetened water for easier administration in infants.

Elderly Patients:
No dosage adjustment is needed unless renal failure is present.

Always consult a registered healthcare professional before using any medication.

Interactions

Intrax, a synthetic amino acid, is incompatible with penicillin solutions (e.g., Benzyl penicillin). It may also have antagonistic effects with thrombolytic agents like Streptokinase and Urokinase. The risk of thrombus formation may increase with concurrent use of estrogen-containing medications, such as oral contraceptives. Direct mixing with whole blood during transfusions should be avoided.

Contraindications

Avoid use in individuals with known hypersensitivity to the product. Contraindicated in thromboembolic diseases, arterial and venous thrombosis, endocavitary hemorrhages, and severe renal failure.

Side Effects

Intrax is generally well-tolerated, but may occasionally cause:

• Fatigue
• Conjunctival irritation
• Nasal blockage
• Itching and skin redness
• Exanthems
• Nausea, diarrhea, or gastric pyrosis after oral use
• Rare instances of postural hypotension

If hypersensitivity occurs, discontinue use and initiate appropriate treatment.

Pregnancy & Lactation

Due to unknown transplacental effects, tranexamic acid should not be used during known or suspected pregnancy. It is present in breast milk at about 1% of maternal blood concentration, making antifibrinolytic effects in infants unlikely.

Precautions & Warnings

• Use only in cases of hyperfibrinolysis. Prophylactic treatment should start 24 hours prior to surgery and continue for 3-4 days post-operation.
• Hemorrhage therapy should extend for at least 24 hours after bleeding has ceased.
• In cases of hematuria without other hemorrhagic symptoms, reduce doses to prevent urinary tract clot formation.
• Use with caution in patients with serious renal issues or anuria, and monitor closely in those with less severe renal dysfunction.
• Careful administration is required in patients with cardiac or liver conditions.

Therapeutic Class

• Anti-fibrinolytic drugs
• Hemostatic agents

Storage Conditions

Store in a dry place at temperatures between 15-30°C, away from light, and keep out of reach of children.