# Tranexamic Acid: veterinary dose and monograph

> Tranexamic Acid is a veterinary drug. A FIBRINOLYSIS INHIBITOR (Plumb’s 10e pp.1264–1266). Indications include prevention / reduction of post-operative bleeding (dogs, cats); traumatic bleeding (dogs, cats); hyperfibrinolysis associated with Angiostrongylus vasorum (dogs). This monograph lists 5 reference doses for dogs and cats, each with route, frequency and source.

Source: https://vetmasterji.com/drugs/tranexamic-acid · Last reviewed: 2026-10-01

## At a glance

- **Drug class:** Veterinary drug
- **Also known as:** TXA, Cyklokapron, Trapic, Pause
- **Species with doses:** Dogs and Cats
- **General dose range:** 10 mg/kg IV Per indication — check the species tables for the indication
- **Routes:** IV
- **Last reviewed:** 1 October 2026

## Indications

- Prevention / reduction of post-operative bleeding (dogs, cats)
- Traumatic bleeding (dogs, cats)
- Hyperfibrinolysis associated with Angiostrongylus vasorum (dogs)
- Induction of emesis (dogs)
- Surgical blood loss during carcinoma / sarcoma removal (cats)

## Tranexamic Acid dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

### Dogs

*Tranexamic Acid doses for dogs*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Adjunctive treatment of bleeding — IV bolus | 10 mg/kg | IV | Once over 2 minutes, then 10 mg/kg/h CRI for 3 hours | — |
| Adjunctive treatment of bleeding — CRI | 10 mg/kg/h | IV | CRI after the 10 mg/kg IV bolus | 3 hours |
| Hyperfibrinolysis — Angiostrongylus vasorum | 10–20 mg/kg | IV | Over 15–20 minutes; repeat 6–8 hours later based on TEG | — |
| Induction of emesis | 50 mg/kg | IV | Single IV bolus | — |

- Adjunctive treatment of bleeding — IV bolus: Plumb’s 10e p.1265 (extra-label): 10 mg/kg IV over 2 minutes, followed by 10 mg/kg/hour IV CRI for 3 hours. Give the bolus over the full 2 minutes: vomiting is more likely with a rapid bolus.
- Adjunctive treatment of bleeding — CRI: Plumb’s 10e p.1265 (extra-label): 10 mg/kg/hour IV CRI for 3 hours, following a 10 mg/kg IV bolus given over 2 minutes.
- Hyperfibrinolysis — Angiostrongylus vasorum: Plumb’s 10e p.1265 (extra-label): control of hyperfibrinolysis associated with Angiostrongylus vasorum infection — 10–20 mg/kg IV over 15 to 20 minutes; repeat 6 to 8 hours later based on thromboelastography (TEG) testing.
- Induction of emesis: Plumb’s 10e p.1265 (extra-label): in one study, 50 mg/kg IV bolus induced vomiting in all dogs (n = 10) without adverse effects; lower doses (20–40 mg/kg IV) were not uniformly effective. Emesis began at a median of ≈2 minutes and lasted ≈2.5 minutes (median 2 episodes).

### Cats

*Tranexamic Acid doses for cats*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Surgical bleeding — carcinoma / sarcoma removal | 15 mg/kg | IV | Single bolus at anaesthetic induction | — |

- Surgical bleeding — carcinoma / sarcoma removal: Plumb’s 10e p.1265 (extra-label): 15 mg/kg IV bolus given during anaesthetic induction reduced surgical blood loss and shortened the activated clotting time (ACT) without altering PT or aPTT. This is the only cat dose Plumb’s gives.

### Horses

*Tranexamic Acid doses for horses*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| No reference dose for this species | No horse dose in Plumb’s 10e or Papich 5e — do not extrapolate from dogs or cats | — | — | — |

- No reference dose for this species: Plumb’s 10e (pp.1264–1266) doses tranexamic acid for dogs and cats only. Its horse data are in-vitro pharmacology (≈10× the potency of aminocaproic acid; ≈6 µg/mL inhibits experimentally induced hyperfibrinolysis, p.1265), not a clinical dose. Papich 5e has no tranexamic acid monograph.

## Contraindications

Plumb’s 10e p.1265: hypersensitivity; a history of, risk for, or active thromboembolic disease. In humans, contraindicated in subarachnoid haemorrhage (cerebral oedema). Renal impairment requires a dose reduction. INADVERTENT INTRATHECAL ADMINISTRATION IS RAPIDLY FATAL (seizures, cardiac arrhythmias). Discontinue if ocular or vision disturbances occur. Upper-urinary-tract bleeding: ureteral obstruction by clot has occurred.

## Species-specific warnings

> **Caution:** Cats: Cats with cardiomyopathy are prone to arterial thromboembolism, and Plumb’s contraindicates tranexamic acid with any thromboembolic risk. Plumb’s only cat dose is a single 15 mg/kg IV bolus at induction for tumour surgery.

> **Caution:** Dogs: Dose-dependent vomiting within ≈2 minutes of IV dosing (85% of dogs in one cohort); tonic-clonic seizures have been reported (Plumb’s 10e p.1265).

## Adverse effects

- Vomiting — dose-dependent, within minutes of IV dosing, more likely with a rapid bolus; maropitant IV 10 minutes before prevents it (dogs)
- Tonic-clonic seizures (reported in dogs)
- Hypotension if given IV too rapidly
- Thrombosis / thromboembolism with IV use; anaphylaxis and peri-operative convulsions (humans)
- Visual changes including ocular / retinal occlusion (humans)

## Drug interactions

- Chlorpromazine: may increase the risk of bleeding (Plumb’s 10e p.1265)
- Oestrogens: increased risk of thrombotic events with combined use
- Thrombolytics (e.g. alteplase): concomitant use may reduce the efficacy of both agents

## Pregnancy and lactation

Plumb’s 10e p.1265: crosses the placenta, reaching concentrations near maternal blood levels. No fetal harm or impaired fertility in laboratory animals at up to 4× the maximum human dose, but safety in pregnancy is not established — use only when maternal benefit outweighs the risk to offspring. Distributed into milk: use with caution in lactating animals or consider milk replacer.

## Monitoring

- Thromboelastography (TEG)
- Baseline and periodic CBC and platelets as indicated by clinical condition
- Vision changes or deficits
- Blood pressure during IV use; renal function (dose reduction in renal impairment)

## Toxicity and overdose

Plumb’s 10e p.1265: GI distress, hypotension, myoclonus and thromboembolic events may occur. Retinal changes including degeneration occurred in dogs, cats and rats given 3–40× the human dose for 6 days to 1 year. Inadvertent intrathecal administration can be rapidly fatal. Not appreciably metabolised; excreted unchanged in urine (human half-life ≈2 h IV) — accumulates in renal impairment.

Management: No specific antidote. GI decontamination should not be necessary but can be considered in a patient that has not vomited; supportive and symptomatic care (Plumb’s 10e p.1265). Inadvertent intrathecal injection: contact an animal poison control centre immediately.

## Clinical pearls

- Stops clots from breaking down rather than forming them — it is a fibrinolysis inhibitor, not a procoagulant
- Emetogenic in dogs: give the bleeding bolus over the full 2 minutes, or pre-treat with maropitant IV 10 minutes beforehand (Plumb’s 10e p.1265)
- The same drug is an IV emetic in dogs at 50 mg/kg — do not confuse the haemostatic and emetic doses
- Avoid in patients with a history of, or risk for, thromboembolic disease
- Reduce the dose in renal impairment (excreted unchanged in urine)

## Mechanism of action

A synthetic lysine derivative that reversibly binds the lysine-binding sites on plasminogen, preventing plasminogen from binding fibrin and so preventing plasmin formation. Inhibiting plasmin-mediated fibrin dissolution stabilises the clot matrix (Plumb’s 10e p.1265). It does not promote clot formation; it prevents clot dissolution. ≈4× as potent as aminocaproic acid in dogs in vitro. Emesis may be mediated by NK1 receptors; GABA/glycine-receptor antagonism may explain its proconvulsant effect.

## Formulations and products

- Injection 100 mg/mL
- 500 mg tablet
- Trapic / Pause — 500 mg tablet; 100 mg/mL injection, Tablet / injection (human-label)
- Cyklokapron — 500 mg tablet; 100 mg/mL injection, Tablet / injection (human-label)

## Storage

Tablets and injection at 20–25 °C (excursions 15–30 °C). Injection is compatible with saline, balanced electrolyte, dextrose, amino-acid and dextran solutions, and heparin may be added. Do NOT mix with blood; incompatible with penicillins (penicillin G, ampicillin, piperacillin) (Plumb’s 10e p.1266).

## Before you use this dose

> **Caution:** Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

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## Frequently asked questions

### What is the dose of Tranexamic Acid for dogs?

Reference doses for Tranexamic Acid in dogs: 10 mg/kg IV Once over 2 minutes, then 10 mg/kg/h CRI for 3 hours (Adjunctive treatment of bleeding — IV bolus); 10 mg/kg/h IV CRI after the 10 mg/kg IV bolus for 3 hours (Adjunctive treatment of bleeding — CRI); 10–20 mg/kg IV Over 15–20 minutes; repeat 6–8 hours later based on TEG (Hyperfibrinolysis — Angiostrongylus vasorum); 50 mg/kg IV Single IV bolus (Induction of emesis). Confirm against the label and the patient before use.

### What is the dose of Tranexamic Acid for cats?

Reference doses for Tranexamic Acid in cats: 15 mg/kg IV Single bolus at anaesthetic induction (Surgical bleeding — carcinoma / sarcoma removal). Confirm against the label and the patient before use.

### Can Tranexamic Acid be given to horses?

No horse dose in Plumb’s 10e or Papich 5e — do not extrapolate from dogs or cats (No reference dose for this species).

### When should Tranexamic Acid not be used?

Plumb’s 10e p.1265: hypersensitivity; a history of, risk for, or active thromboembolic disease. In humans, contraindicated in subarachnoid haemorrhage (cerebral oedema). Renal impairment requires a dose reduction. INADVERTENT INTRATHECAL ADMINISTRATION IS RAPIDLY FATAL (seizures, cardiac arrhythmias). Discontinue if ocular or vision disturbances occur. Upper-urinary-tract bleeding: ureteral obstruction by clot has occurred.

### What are the side effects of Tranexamic Acid in animals?

Vomiting — dose-dependent, within minutes of IV dosing, more likely with a rapid bolus; maropitant IV 10 minutes before prevents it (dogs); Tonic-clonic seizures (reported in dogs); Hypotension if given IV too rapidly; Thrombosis / thromboembolism with IV use; anaphylaxis and peri-operative convulsions (humans); Visual changes including ocular / retinal occlusion (humans).

## Sources

- Plumb's Veterinary Drug Handbook
- Merck Veterinary Manual, 11th edition
- Papich, Papich Handbook of Veterinary Drugs, 5th edition

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VetMasterJi is a clinical decision-support and education platform for veterinary professionals and students. It does not provide veterinary advice, diagnosis or treatment for specific animals. All drug doses, calculators and differentials are references that must be independently verified before clinical use; the attending registered veterinarian remains solely responsible for every clinical decision.