Tranexamic acid is an antifibrinolytic agent primarily used to reduce bleeding or prevent fibrin degradation. This medication works by inhibiting the activity of plasmin, thereby prolonging the hemostatic effect after blood clot formation. It is commonly used in surgical procedures, heavy menstrual bleeding, or specific bleeding disorders.
Its mechanism involves blocking the fibrinolytic process, making formed clots less susceptible to breakdown. Therefore, it is suitable for medical situations requiring enhanced hemostasis. The drug can be administered orally or via intravenous injection, with rapid onset of action, but must be used strictly according to medical instructions.
The generic name of tranexamic acid is Tranexamic Acid. Common brand names include:
Tranexamic acid is classified as an antifibrinolytic agent, a type of hemostatic medication. These drugs mainly act on the later stages of the blood coagulation process, differing from anticoagulants or antiplatelet agents.
This medication is mainly used for:
In special cases, it may be used to reduce nosebleeds or bleeding caused by certain cancer chemotherapies, but this should be evaluated and prescribed by a physician.
Mild side effects include:
Serious Side Effects: May increase the risk of thrombosis, such as deep vein thrombosis or pulmonary embolism. Symptoms like unilateral limb swelling or difficulty breathing require immediate medical attention. Allergic reactions such as rash or urticaria should also be monitored closely.
Contraindications: Patients with a history of thrombosis, arterial embolism, or severe liver/kidney dysfunction should not use this medication. Pregnant women should use it only after medical evaluation, and breastfeeding women should avoid or discontinue use.
The black box warning indicates that this drug may induce retinal vascular occlusion, especially with high doses or prolonged use. Sudden vision loss requires immediate discontinuation and retinal examination.
Concurrent use with anticoagulants (e.g., warfarin) may increase bleeding or thrombosis risk, requiring dose adjustments. Combining with non-steroidal anti-inflammatory drugs (NSAIDs) may exacerbate gastrointestinal bleeding. Avoid simultaneous use with antiplatelet agents (e.g., aspirin), as it may reduce efficacy or increase side effects. Always inform your healthcare provider of all medications and supplements being taken.
Oral doses are typically 10-25 mg per kilogram of body weight, taken 2-3 times daily, preferably with meals to reduce gastrointestinal discomfort. Intravenous injections should be administered by healthcare professionals, with speed and dosage adjusted based on the condition.
For uterine bleeding, high doses (e.g., single doses of 10-15 mg/kg) may be used, while for heavy menstrual bleeding, short-term cyclic use is common. Pediatric doses should be adjusted according to weight and age. Do not alter the prescribed regimen without medical advice.
If a dose is missed, take it as soon as remembered. If it is close to the next scheduled dose, skip the missed dose and resume the normal schedule. Do not double doses to make up for missed ones, as this may increase the risk of side effects.
Overdose can lead to severe thrombosis or renal toxicity, with symptoms such as severe headache, confusion, or decreased urine output. Seek immediate medical attention for gastric lavage or supportive treatment. If retinal hemorrhage or vision loss occurs, urgent ophthalmologic evaluation and antidote administration are necessary. Hemodialysis may be used to remove excess drug.
Tranexamic acid can be taken with or without food. If gastrointestinal discomfort occurs, taking it with meals is recommended to reduce stomach irritation. Avoid concurrent intake of high-calcium foods (e.g., cheese, milk) as calcium may affect drug absorption. Take the medication at fixed times to maintain stable blood levels.
Q: What should I do if abnormal bleeding occurs during treatment?While tranexamic acid may increase thrombosis risk, if unexplained bleeding such as gum bleeding, sudden increase in menstrual flow, or hematuria occurs, discontinue the medication and seek medical attention. Mild headaches or nausea are usually short-term side effects; persistent discomfort should be reported to a doctor. The physician may adjust the dose or recommend other hemostatic measures.
Q: What are the risks of combining tranexamic acid with anticoagulants like warfarin?Using tranexamic acid with anticoagulants may reduce anticoagulant effects and increase thrombosis risk. If combined, blood coagulation parameters (e.g., INR) should be closely monitored, and anticoagulant doses adjusted accordingly. Patients should inform their healthcare provider of all medications, including over-the-counter drugs and supplements.
Q: Should I stop taking tranexamic acid before surgery or dental procedures?Inform your doctor 3-7 days prior to planned surgery or invasive procedures. The physician may temporarily discontinue the medication to reduce bleeding or thrombotic complications during the procedure. Resumption of therapy should be based on postoperative recovery and reassessment of risks.
Q: Does long-term use of tranexamic acid cause liver or kidney problems?Prolonged use may cause mild effects on liver and kidney function, but severe damage is rare. Regular blood tests every 3-6 months are recommended to monitor liver enzymes and creatinine levels. Discontinue and seek medical attention if jaundice, dark urine, or lower limb edema develop.
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