Who should not take tranexamic acid?

1.What is tranexamic acid?

Tranexamic acid (TXA) is a synthetic antifibrinolytic agent that works by inhibiting the activation of plasminogen to plasmin, an enzyme responsible for the breakdown of fibrin in blood clots.  By binding to the lysine binding sites of plasminogen and plasmin, it effectively reduces fibrinolysis, thereby stabilizing blood clots and promoting hemostasis.

Clinically, tranexamic acid is widely used in various medical settings to control excessive bleeding.  It is commonly employed during and after surgical procedures, particularly in orthopedic and dental surgeries, where blood loss can be significant.  TXA is also used in the treatment of heavy menstrual bleeding, a condition known as menorrhagia, and in the management of traumatic hemorrhage, such as in patients with severe injuries or those undergoing major trauma.

Moreover, tranexamic acid has been studied for its potential benefits in treating conditions like postpartum hemorrhage, nosebleeds, and even in reducing the risk of bleeding in patients undergoing fibrinolytic therapy.  It can be administered orally or intravenously, with the dosage and method depending on the clinical condition being treated.

Although generally well-tolerated, tranexamic acid is not without its risks.  Potential side effects may include gastrointestinal disturbances, headaches, and in rare cases, thromboembolic events, particularly in patients with a predisposition to blood clots. 

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2.How should I use this tranexamic acid?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Do not cut, crush, or chew this medicine. You can take it with or without food. If it upsets your stomach, take it with food. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor's advice.

Do not take this medicine until your period has started. Do not take it for more than 5 days in a row. Do not take this medicine when you do not have your period.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for female children as young as 12 years of age for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

3.Tranexamic acid dosing information？

⇒ Usual Adult Dose for Bleeding:

Initial dose: 10 mg/kg intravenously, immediately before dental extraction

Maintenance dose: 10 mg/kg intravenously three to four times daily

Duration of therapy: 2 to 8 days

Comment: Infuse no more than 1 mL/minute to avoid hypotension.

Use: Short-term use in patients with hemophilia to reduce or prevent hemorrhage and reduce the need for replacement therapy during and following a tooth extraction.

⇒ Usual Adult Dose for Menstrual Disorders:

Tablets:

Dose: 1300 mg (two 650 mg tablets) orally three times a day (3900 mg/day) during monthly menstruation

Duration: Maximum of 5 days

Use: For the treatment of cyclic heavy menstrual bleeding

⇒ Usual Pediatric Dose for Bleeding:

Initial dose: 10 mg/kg intravenously, immediately before dental extraction

Maintenance dose: 10 mg/kg intravenously three to four times daily

Duration of therapy: 2 to 8 days

⇒ Comments:

-The limited data suggest that dosing instructions for adults can be used for pediatric patients needing therapy for tooth extractions.

-Infuse no more than 1 mL/minute to avoid hypotension.

Use: Short-term use in patients with hemophilia to reduce or prevent hemorrhage and reduce the need for replacement therapy during tooth extractions.

⇒ Usual Pediatric Dose for Menstrual Disorders:

Tablets:

Dose: 1300 mg orally three times a day (3900 mg/day) during monthly menstruation

Duration: Maximum of 5 days

Use: For the treatment of cyclic heavy menstrual bleeding in post-menarchal females

4.How long to take it for？

Tranexamic acid is usually used for a short time to treat bleeding. You'll usually take this medicine for 4 days for heavy periods, or for 7 days to treat other bleeding that does not stop by itself.If you have a condition such as hereditary angioedema you may need to take it when needed, for example when you have a procedure such as dental treatment.

If you forget to take it

If you forget to take your dose of tranexamic acid, take it as soon as you remember, unless it's nearly time for your next dose. In this case, skip the missed dose and take the next one at the usual time.Do not take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.If you forget doses often, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking 1 extra dose of tranexamic acid powder is unlikely to harm you.However, if you take too much you may get side effects. These can include feeling or being sick, diarrhoea and feeling dizzy. Speak to your doctor if you're worried or if these side effects are troubling you.

Reference:

https://my.clevelandclinic.org/health/drugs/20792-tranexamic-acid-oral-tablets

https://www.drugs.com/mtm/tranexamic-acid

https://www.nhs.uk/medicines/tranexamic-acid/how-and-when-to-take-tranexamic-acid/.