routes of administration

Alternative Routes to
Intravenous TXA Administration

Intravenous (IV) Tranexamic Acid (TXA) reduces death from bleeding in patients with postpartum haemorrhage (PPH) and traumatic injuries.  

However, patients must be treated urgently – most haemorrhage deaths occur within hours of bleeding onset, and treatment delay reduces the survival benefit from TXA. With every 15 minute delay, 10% of the survival benefit is lost. 

One of the main obstacles to reducing treatment delay is the need for an IV injection. 

In trauma patients, securing IV access at the injury scene can be difficult, particularly in trapped patients.

In countries with limited pre-hospital care, most trauma patients arrive at hospital too late to benefit from TXA. 

The WOMAN trial showed that IV administration of TXreduces PPH deaths by one-third, TXA was incorporated into the World Health Organisation guidelines. 

To ensure equitable access to this life-saving treatment, finding other routes to give TXA became a WHO priority.  

Because many women die soon after PPH onset and the life-saving effect of TXA decreases by 10% with every 15-minute delay, finding alternatives to IV administration offers women effective emergency care wherever they give birth. 

Click HERE to watch a PPH stakeholder webinar discussing alternative routes for the administration of tranexamic acid (TXA) in post-partum haemorrhage (PPH).

Learn About Different Routes of Administration

Routes Of

What concentration of tranexamic acid is needed to inhibit fibrinolysis?

A systematic review to determine the minimal concentration of TXA in the blood that is required to inhibit fibrinolysis

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PBPK Trial

Physiologically based modeling of tranexamic acid pharmacokinetics following intravenous, intramuscular, subcutaneous, and oral administration in healthy volunteers

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PharmacoTXA Trial Protocol

This isPhase 1 trial in healthy volunteerto determine the bioavailability and pharmacokinetics of TXA following administration of TXA by different routes and relevant doses

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WOMANPharmaco-TXA Trial Protocol

This is a Phase 2 trial assessing the pharmacokinetics and pharmacodynamics of tranexamic acid administered by intravenous, intramuscular and oral liquid routes in women giving birth by caesarean section with at least one risk factor for PPH 

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WOMANPharmaco-TXA Trial

The main aim of this study is to ascertain whether IM and oral solution of TXA will be well absorbed at levels sufficient to inhibit fibrinolysis in pregnant women.

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Intramuscular injection of TXA in Bleeding Trauma Patients

Trauma-INTACT Trial Results

The Trauma-INTACT trial is an open-label, multi-centre pharmacokinetics study of IM TXA. The results show that TXA is well tolerated and rapidly absorbed via the IM route in bleeding trauma patients

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IM TXA means huge implications for trauma care

1g intramuscular TXA shown to be well tolerated & reach a therapeutic level of 5mg/L-1 in 4 mins, remaining > this conc for 10hrs

TXA in military

For soldiers, assault victims, war & terrorism casualties, etc, early admin of TXA could be the difference between life or death. First responders could administer worldwide in all settings with IM being a simple alternative administration route to IV TXA

Trauma-INTACT Trial Protocol

Pharmacokinetics of intramuscular tranexamic acid in trauma patients: a clinical trial

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Stakeholder webinar: Alternative routes for the administration of tranexamic acid (TXA) in post-partum haemorrhage (PPH)

Post-partume haemorrhage stakeholders Webinar: Alternative routes for the administration of tranexamic acid (TXA) in post-partum haemorrhage (PPH)

Stakeholder webinar summary: view PDF

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