What is the pediatric TXA dose for patients with no evidence of puberty?

• A. 5 mg/kg in 100 ml
• B. 15 mg/kg in 100 ml, 10 drop set, 3 drops per second over approximately 5 min (2 g max dose)
• C. 30 mg/kg in 100 ml
• D. 50 mg/kg in 50 ml

Answer: (B)

The main idea is to dose tranexamic acid in children based on weight and to limit the total amount to avoid high plasma levels, especially when there’s no puberty. For prepubertal kids, the standard approach is a total dose of about 15 mg per kilogram, diluted in around 100 mL and given as a rapid infusion over roughly five minutes. Using a 10-drop/mL set and delivering about 3 drops per second achieves that time frame, so the patient receives the full weight-based dose within about five minutes. A maximum total dose of 2 g keeps the amount safe even in larger children.

That’s why this option lines up with the dosing pattern: 15 mg/kg in 100 mL, infused over ~5 minutes with a 10-drop/mL set at about 3 drops per second, not exceeding 2 g in total. The other choices don’t match the standard prepubertal dosing in either the amount per kilogram, the dilution/infusion rate, or the maximum total dose, so they’re not appropriate for this scenario.