tranexamic acid/mefenamic acid

Action and Spectrum

Actions and spectrum:

Tranexamic Acid interferes with the stabilization of blood clots by inhibiting plasminogen from initiating the process, and this process of hemostasis can be seen in IDAs such as heavy menstrual bleeding, postoperative hemorrhage or trauma. Mefenamic Acid is a NSAID which prevents COX enzymes from fulfilling their function, hence the production of prostaglandins is reduced which will finally helps in pain, inflammation reduction. It acts on COX-1 and   COX-2, two main pathways whereby it operates to reduce transmitter sensitization of pain peripheral nerve   as well as prostaglandin-induced inflammatory actions.

Drug Interaction

Adverse Reaction

Adverse Reaction 

• Vomiting
• Nausea
• Diarrhea
• Headache
• Back pain
• Muscle pain

Black Box Warning

Black box warning:

None

Contraindication / Caution

Contraindications/caution 

Hepatic impairment

Renal impairment

Pregnancy / Lactation

Pregnancy/Lactation 

Pregnancy warnings:

Pregnancy Category: It is not recommended during the first trimester.

Lactation: Excretion of the drug in human breast   milk is unknown.

Pregnancy Categories: 

• Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.
• Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
• Category N: There is no data available for the drug under this category.

Pharmacology

Pharmacology:

By preventing plasminogen from starting the hemostasis process, tranexamic acid prevents blood clots from stabilising. Hemostasis can be observed in IDAs such as severe menstrual bleeding, surgical haemorrhage, or trauma. Mefenamic acid is an NSAID that works by inhibiting COX enzymes from doing their role. As a result, prostaglandin synthesis is decreased, which ultimately aids in the relief of pain and inflammation. It reduces prostaglandin-induced inflammation and transmitter sensitization of peripheral nerve pain by acting on COX-1 and COX-2, two major routes.

Pharmacokinetics: 

Absorption 

The bioavailability of tranexamic acid is 34% and mefenamic acid is 90%.

Distribution 

The drug is distributed throughout the   body.

Metabolism 

It undergoes hepatic metabolism.

Elimination and Excretion 

The elimination half of tranexamic acid/mefenamic acid is 3.1  and 2  hours, respectively, and excreted renally.

Adminstartion

Administration: 

The drug can be taken orally in tablet form.

Patient Information Leaflet

Patient information leaflet 

Generic Name: tranexamic acid/mefenamic   acid

Why do we use tranexamic acid/mefenamic acid? 

Tranexamic acid can be used for regulating heavy periods; on the other hand, mefenamic acid helps with menstrual cramps.

To stop bleeding during surgeries or severe traumas, tranexamic acid may be used; mefenamic acid will help for pain relief in the postoperative period.