Tranexamic acid is a medication primarily used to control and prevent heavy menstrual bleeding. It is also frequently utilized to manage bleeding during surgeries, dental procedures, and physical trauma.
This medication is available in US pharmacies as a generic or under the brand name Lysteda for oral use. It should only be taken under the direct supervision of a healthcare professional.
In addition to oral forms, tranexamic acid may be used as a compounded cream for skin conditions like melasma. In hospital settings, it is often administered via injection under the brand name Cyklokapron to treat emergency cases of severe blood loss.
What it is used for
Tranexamic acid may be recommended for several purposes:
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Reducing heavy menstrual bleeding, medically referred to as menorrhagia.
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Lightening dark skin patches, particularly melasma.
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Lowering the risk of bleeding after surgeries, such as bladder procedures, prostatectomies, or cervical conization.
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Controlling severe nosebleeds, also known as epistaxis.
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Preventing excessive bleeding during tooth extractions in patients with hemophilia.
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Treating hemorrhages linked to excessive fibrinolysis.
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Preventing recurrent bleeding within the eye.
Regardless of the form used, this medication must only be administered with a doctor’s prescription and oversight.
How it works
As an antifibrinolytic, tranexamic acid works by blocking the action of plasminogen. This is the enzyme responsible for dissolving blood clots; by inhibiting it, the medication stabilizes fibrin and reduces active bleeding.
When applied topically or taken for skin concerns, it appears to interfere with melanin production. This makes it an effective option for lightening certain skin discolorations, especially melasma. Read more about melasma treatment and what your doctor can prescribe.
How to use
Oral tablets or capsules should be swallowed with a full glass of water at the specific intervals prescribed by your doctor.
For the cream formulation, apply the product directly to the affected skin area once the skin has been properly cleansed.
In a clinical or hospital setting, the injectable form is administered intravenously by a healthcare professional under medical supervision.
Tranexamic acid dosage
The dosage depends on the specific condition being treated and the form of the medication:
1. Lysteda and generic tranexamic acid
Vrious strengths may be used for adult and pediatric conditions based on medical necessity.
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Bleeding from surgery or trauma: Adults typically take 1000 mg to 1500 mg, 2 to 3 times daily. Children are usually dosed at 10 mg per kg of body weight, 2 to 3 times daily.
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Prostatectomy recovery: Treatment often begins with an injection in the hospital, followed by 1000 mg to 1500 mg, 3 to 4 times daily.
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Heavy menstrual bleeding (menorrhagia): The typical US dosage is two 650 mg tablets (1300 mg) taken 3 times daily for up to 5 days during menstruation.
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Nosebleeds (epistaxis): 1000 mg to 1500 mg, 3 times daily, for 7 days.
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Hemophilia (dental prep): 1000 mg to 1500 mg every 8 hours.
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Hereditary angioedema: 1000 mg to 1500 mg, 2 to 3 times daily, for several days.
Patients with kidney impairment (renal insufficiency) require adjusted doses based on their serum creatinine levels. Always follow the specific instructions provided by your physician.
2. Tranexamic acid cream
For 3% tranexamic acid cream, the standard application is once or twice daily on clean, dry skin. This is usually a compounded product designed to help fade dark spots associated with melasma.
3. Compounded tranexamic acid capsules
In the US, specific strengths such as 500 mg capsules are typically prepared by compounding pharmacies. The common dosage for adults is one capsule, 2 to 3 times daily for up to 4 days, ensuring the total daily intake does not exceed 4 g.
4. Injectable tranexamic acid (Cyklokapron)
The 100 mg/mL injectable solution is dosed individually by a physician. For adults, this often involves 500 to 1000 mg via slow intravenous injection three times a day.
Subsequent maintenance may involve a diluted infusion of 25 to 50 mg per kg of body weight per day. For children, the dose is generally 10 mg per kg of body weight per dose, 2 to 3 times daily. Smoking and alcohol consumption are not recommended during treatment with the injectable form.
Possible side effects
Common side effects include nausea, vomiting, diarrhea, general discomfort, low blood pressure, and skin irritation such as itching or redness.
Occasionally, this medication can cause visual changes, particularly regarding color perception, and may increase the risk of blood clots in the eyes.
Serious allergic reactions (anaphylaxis) can occur. Seek immediate help if you experience swelling of the lips or tongue, wheezing, or difficulty breathing.
If you notice swelling, pain, or redness in a leg, seek emergency care immediately. These symptoms can indicate a blood clot (DVT), which may travel to the lungs and cause chest pain or shortness of breath.
Who should not use it
Tranexamic acid is contraindicated for individuals with:
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A history of thrombosis, embolism, heart attack, or ischemia.
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Active disseminated intravascular coagulation.
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A known allergy to any of the medication's ingredients.
Use during pregnancy or while breastfeeding requires strict medical supervision. Additionally, those with urinary tract bleeding or a family history of blood clots should consult a doctor before use. Women using oral contraceptives should be aware that taking this medication concurrently can increase the risk of blood clots.
Common questions about tranexamic acid
1. How long does it take for tranexamic acid to stop a period?
It does not stop menstruation entirely. Instead, it helps the body manage and reduce blood loss, making the flow lighter and more manageable.
2. Can I take two tablets at once?
Yes, taking two tablets at once (specifically the 650 mg tablets for heavy periods) is the standard prescribed dose for adults in the US, provided it is directed by your doctor.
3. Does tranexamic acid cause blood clots?
It can increase the risk of thrombosis in individuals who are already predisposed to clotting, as the drug's purpose is to prevent the breakdown of clots.
4. Does it cause drowsiness?
There is currently no medical evidence suggesting that tranexamic acid causes sleepiness or drowsiness.
5. Does it cause weight gain?
No, it does not affect metabolism, hunger hormones, or satiety, so it does not lead to weight gain.
6. Does it interfere with birth control?
It does not reduce the effectiveness of birth control. However, taking both can significantly increase your risk of developing blood clots, so a consultation with a gynecologist is essential.