activated prothrombin complex concentrate + tranexamic acid

This is a combination therapy consisting of activated prothrombin complex concentrate (aPCC) and tranexamic acid. Activated prothrombin complex concentrate, commonly known as FEIBA, is a plasma-derived product containing multiple vitamin K-dependent clotting factors (mainly II, IX, X in inactive forms and VII in an activated form). It acts by providing these coagulation factors to bypass inhibitors in patients with hemophilia A or B who have developed inhibitors to factor VIII or IX. Tranexamic acid is a synthetic antifibrinolytic agent that inhibits plasminogen activation and plasmin activity, thereby preventing the breakdown of fibrin clots. The combination has been used for the treatment and prevention of bleeding episodes—especially mucosal bleeding—in patients with hemophilia A (with inhibitors), acquired hemophilia A, or other coagulopathies where both enhanced clot formation and inhibition of fibrinolysis are desired[1][2][3][4]. This regimen may also be considered off-label for acute traumatic coagulopathy[5].