Comparison of tranexamic acid plasma concentrations when administered via intraosseous and intravenous routes

Introduction: There is a lack of information regarding intraosseous (IO) administration of tranexamic acid (TXA). Our hypothesis was that a single bolus IO injection of TXA will have a similar pharmacokinetic profile to TXA administered at the same dose IV. Methods: Sixteen male Landrace cross swine (mean body weight 27.6 +/- 2.6 kg) were divided into an IV group (n = 8) and an IO group (n = 8). Each animal received 30 mg/kg TXA via an IV or IO catheter, respectively. Jugular blood samples were collected for pharmacokinetic analysis over a 3 h period. The maximum TXA plasma concentration (C-max) and corresponding time as well as distribution half-life, elimination half-life, area under the curve, plasma clearance and volume of distribution were calculated. One- and two-way analysis of variance for repeated measures (time, group) with Tukey's and Bonferonni post hoc tests were used to compare TXA plasma concentrations within and between groups, respectively. Results: Plasma concentrations of TXA were significantly higher (p < 0.0001) in the IV group during the TXA infusion. Cmax occurred at 4 min after initiation of the bolus in the IV group (9.36 +/- 3.20 ng/mu l) and at 5 min after initiation of the bolus in the IO group (4.46 +/- 0.49 ng/mu l). Plasma concentrations were very similar from the completion of injection onwards. There were no significant differences between the two administration routes for any other pharmacokinetic variables measured. Conclusion: The results of this study support pharmacokinetic bioequivalence of IO and IV administration of TXA. (C) 2016 Elsevier Inc. All rights reserved.