Description and Composition of Rikavarin
Rikavarin is an antifibrinolytic agent. It contains Tranexamic Acid as its active pharmaceutical ingredient. It also contains inactive ingredients called excipients in sufficient quantities. Rikavarin works to prevent or to control bleeding regardless of the cause. It comes in tablets and injection dosage forms. It also comes as mouth wash and as liquids for children who can’t swallow tablets. Available dosage strengths include 500 mg and 650 mg tablets, plus 100 mg/mL, and 10 mg/mL-NaCl 0.7%.
Uses of Rikavarin
- Rikavarin is used in cyclic heavy menstrual bleeding. To be started during the menstruation.
- It is used in postpartum hemorrhage
- It is used in nose bleeding (Epistaxis).
- It is used in the presence of blood collection in the eyes (Hyphema).
- It is used to control bleeding in some surgical procedures (e.g. Cone Biopsy, during tooth extraction etc). Here, it is given intravenously for short-term use (2-8 days) especially in patients with hemophilia to prevent or reduce bleeding following tooth extraction.
- It is used in hereditary angioedema attack.
Dosage of Rikavarin
500 mg in 5 ml ampoule (100 mg/ml) for slow iv injection or infusion in 0.9% sodium chloride or 5% glucose.
Not to be administered by im route
- Adolescent under 15 years: 15 mg/kg (max. 1 g
- Adult: 1 g (two 5 ml ampoules) in a bag of 100 ml of 0.9% sodium chloride to be administered over 15 minutes within 3 hours of delivery repeat after 30 minutes if bleeding continues or within 24 hours of the first dose if bleeding restarts (max. total dose 2 g)
Indications Based Dosage
- 1300 mg PO TID for up to 5 days during menstruation
- Long term prophylaxis: 1000-1500 mg PO q8-12hr; reduce dose to 500 mg/dose PO qDay or q12hr when frequency of attacks reduces
- Short term prophylaxis: 75 mg/kg/day PO divided q8-12hr for 5 days before and after the event
- Treatment of acute HAE attack: 25 mg/kg/dose PO/IV; not to exceed 1000 mg/Y q3-4hr; not to exceed 75 mg/kg/day or 1000 mg PO q6hr for 48 hr
- 1000-1500 mg q8-12hr x10 days
- 1000-1500 mg q8-12hr x12 days postop
- 1000-1500 mg q8-12hr x10 days
1000-1500 mg PO BID/TID
Side effects of Rikavarin
- Stomach pain
- Muscle or joint pain
- Muscle cramps
How Rikavarin Works
Can Rikavarin be Used in Pregnancy?
Contraindications of Rikavarin
Rikavarin is contraindicated:
- In patients with acquired defective color vision, since this prohibits measuring one endpoint that should be followed as a measure of toxicity.
- In patients with subarachnoid hemorrhage. Anecdotal experience indicates that cerebral edema and cerebral infarction may be caused by Tranexamic acid in such patients.
- Inpatients with active intravascular clotting.
Can Rikavarin be Used While Breast-feeding a Baby?
Where to Adjust Dose of Rikavarin
Adjust dosage of this drug in patient with renal impairment. No dose adjustment is not necessary in hepatic impairment.
In Renal impairment
- Serum Creatinine >1.4 mg/dL and ≤2.8 mg/dL: 1300 mg PO BID
- Serum Creatinine >2.8 mg/dL and ≤5.7 mg/dL: 1300 mg PO qDay
- Serum Creatinine >5.7 mg/dL: 650 mg PO qDay
This write up is not a prescription. You are therefore to strictly rely and adhere to your doctor’s prescription. Remember not to take any drug without consulting your healthcare provider.