TRAFEN

Tranexamic acid 500 mg + mefenamic acid 250 mg

Tranexamic acid exerts antifibrinolytic effect by forming a reversible complex with plasminogen through the lysine binding site of fibrin and thus displaces the plasminogen from the fibrin surface. It prevents the binding of plasmin to fibrinogen or fibrin monomers. It inhibits the activation of plasminogen. It also acts as a weak non competitive inhibitor of plasmin and blocks it`s action on fibrin.

Mefenamic acid has analgesic, anti-inflammatory and antipyretic action. It acts by inhibiting Prostaglandin (PGs) synthesis and their release at the site of injury. Prostaglandins cause tenderness and amplify the action of other analgesics. It inhibits cyclo-oxygenase enzyme and antagonizes prostaglandin actions.

Indications

• Dysmenorrhoea
• Menorrhagia
• Dysfunctional uterine bleeding

Dosage

1 tablet twice daily or as directed by the physician

Contra-indications

• Hypersensitivity to Mefenamic acid and other NSAIDs
• Inflammatory bowel disease
• Peptic ulcer
• Thromboembolic disorders
• Subarachnoid haemorrhage
• Massive upper urinary tract haemorrhage
• Colour vision disorders
• Thrombophlebitis
• Hepatic impairment
• Severe renal impairment

Precautions

• Mild to moderate renal impairment, long term treatment of hereditary angioedema.
• Ureteral obstruction, previous history of thromboembolic disease, concomitant dawn with factor IX complex concentrates or anti- inhibitor coagulant concentrates, thoracic or abdominal surgery, disseminated intravascular coagulation (DIC), haematuria, active intravascular clotting, asthama.
• Monitor blood counts & liver function during long- term therapy. Drowsiness may affect ability to perform skilled tasks.

Side effects

Nausea, Diarrhoea, Gastrointestinal problems, Headache, Hypotension, Giddiness, Thrombophlebitis at injected vein, Impairment of Colour vision, Vomiting, Anorexia, Gastrointestinal bleeding, Abdominal distress, Constipation, Peptic ulcer, Dyspepsia, Flatulence, Drowsiness, Insomnia, Agranulocytosis, Aplastic anaemia, Thrombocytopenia, Dizziness, Rash

Drug Interactions

• Mefenamic acid enhances acitivity of oral anticoagulants but rarely significant.
• Increases risk of GI irritation with alcohol.
• Tranexamic acid has increased risk of thrombus formation with oestrogens.