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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Tranexamic Acid
Brand Name
Tranexamic Acid In Sodium Chloride
Generic Name
Tranexamic Acid
Active Ingredient
Tranexamic AcidCategory
Antifibrinolytic Agent [EPC]
Variants
7
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Tranexamic Acid In Sodium Chloride, you must consult a qualified healthcare professional.
| 10 mg/mL | INJECTION, SOLUTION | INTRAVENOUS | 80830-2329 |
| 10 mg/mL | INJECTION, SOLUTION | INTRAVENOUS | 66298-5340 |
| 10 mg/mL | INJECTION, SOLUTION | INTRAVENOUS | 51754-0108 |
Detailed information about Tranexamic Acid In Sodium Chloride
Tranexamic Acid is a potent antifibrinolytic agent used to prevent or reduce excessive bleeding by stabilizing blood clots. It is commonly prescribed for heavy menstrual bleeding and various surgical procedures.
Dosage of Tranexamic Acid varies significantly based on the condition being treated and the route of administration. Patients must follow the specific regimen prescribed by their healthcare provider.
The standard dose for treating cyclic heavy menstrual bleeding is 1300 mg (two 650 mg tablets) taken three times daily for a maximum of 5 days during monthly menstruation. The total daily dose should not exceed 3900 mg. Treatment should only begin once menstrual bleeding has started; it is not intended for use before the onset of the period or for the prevention of menstruation.
In surgical settings, dosing is often weight-based. A common regimen involves a loading dose of 10 mg/kg to 15 mg/kg administered intravenously before the first incision, followed by an infusion or repeat bolus doses during the procedure, depending on the length of the surgery and the risk of blood loss.
In emergency trauma situations, the standard protocol (derived from the CRASH-2 study) is a 1-gram loading dose infused over 10 minutes, followed by another 1-gram infusion over the subsequent 8 hours. For maximum efficacy, the first dose should be administered as soon as possible, ideally within 3 hours of the injury.
Tranexamic Acid is not FDA-approved for the treatment of heavy menstrual bleeding in patients who have not yet reached menarche (the first menstrual period).
For pediatric patients with hemophilia undergoing dental procedures, weight-based dosing is typically used, often starting at 10 mg/kg intravenously prior to the procedure, followed by oral doses of 25 mg/kg three to four times daily for several days afterward. Pediatric dosing must be meticulously calculated by a specialist, such as a pediatric hematologist.
Since Tranexamic Acid is primarily cleared by the kidneys, dose reductions are mandatory for patients with any degree of renal insufficiency to avoid toxic accumulation. Adjustments are based on serum creatinine levels:
No dosage adjustments are generally required for patients with liver disease, as Tranexamic Acid is not significantly metabolized by the liver.
Geriatric patients often have undiagnosed age-related declines in kidney function. Healthcare providers typically assess renal function (via GFR or creatinine clearance) before initiating therapy in patients over 65 to determine the appropriate dose.
If a dose is missed, it should be taken as soon as the patient remembers. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. Do not double the dose to catch up, as this increases the risk of adverse effects, including blood clots.
Signs of an overdose may include severe nausea, vomiting, diarrhea, dizziness, or visual changes. More seriously, an overdose can lead to seizures or an increased risk of thromboembolic events (clots). In the event of a suspected overdose, contact a poison control center or seek emergency medical attention immediately.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance. If you feel the medication is not effectively controlling your bleeding, consult your doctor rather than increasing the dose yourself.
Most side effects of Tranexamic Acid are mild and transient. The most frequently reported include:
Tranexamic Acid is a potent medication that alters the body's clotting balance. It must only be used under the supervision of a qualified healthcare professional. Patients should be aware that while TXA is effective at stopping bleeding, its mechanism of action inherently carries a risk of promoting unwanted blood clots in the veins or arteries.
No FDA black box warnings for Tranexamic Acid.
The most significant precaution involves the risk of Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), and cerebral thrombosis (stroke). Tranexamic Acid should be used with extreme caution in patients with a history of these conditions. The risk is also increased in patients with 'hypercoagulable' states, such as those with Factor V Leiden, protein C or S deficiency, or active malignancy.
Retinal changes and visual disturbances have been reported in animal studies and rare human cases. If a patient experiences any change in their vision—especially color vision or clarity—they must stop the medication immediately and receive a comprehensive eye exam. For those using the drug for more than several days, baseline and periodic eye exams are often recommended.
The use of Tranexamic Acid with estrogen-progestin combination birth control (pills, patches, or rings) is generally contraindicated or strongly discouraged. Both medications increase the risk of blood clots. When used together, the risk of heart attack, stroke, or pulmonary embolism increases exponentially. Patients requiring TXA for heavy periods should ideally use non-hormonal contraception or progestin-only options (like a hormonal IUD), though even these require a doctor's evaluation.
These medications are used to promote clotting in patients with hemophilia or to reverse the effects of blood thinners. Taking them alongside Tranexamic Acid can lead to an excessive prothrombotic state, where the body forms clots too easily throughout the vascular system. This combination should only be used in specialized hospital settings under the guidance of a hematologist.
In patients with acute promyelocytic leukemia being treated with tretinoin, the addition of Tranexamic Acid may increase the risk of severe thrombotic complications. Close monitoring for signs of clots is required.
Tranexamic Acid must NEVER be used in the following circumstances:
Tranexamic Acid is classified as Pregnancy Category B. Animal studies have shown no evidence of impaired fertility or harm to the fetus. In humans, TXA is frequently used 'off-label' to treat severe postpartum hemorrhage (bleeding after birth), and the WOMAN trial (2017) demonstrated it is life-saving in this context. However, it should only be used during pregnancy if clearly needed and prescribed by an obstetrician, particularly in the first trimester, as it does cross the placenta.
Tranexamic Acid is excreted into human breast milk, but the concentration is approximately 1/100th of the concentration found in the mother's plasma. It is generally considered compatible with breastfeeding, but nursing mothers should monitor their infants for any unusual symptoms and discuss the use with a pediatrician.
Tranexamic Acid is a competitive inhibitor of plasminogen activation. At the molecular level, it binds to the four or five lysine-binding sites on the Kringle domain of plasminogen. This prevents the plasminogen from associating with fibrin, which is a necessary step for the formation of the enzyme plasmin. By inhibiting plasmin formation, Tranexamic Acid preserves the fibrin meshwork of a blood clot, effectively 'stabilizing' the clot against degradation by the body's natural fibrinolytic system.
The onset of action for intravenous TXA is nearly immediate. For oral TXA, the effect on menstrual blood loss is typically seen within the first cycle of use. The duration of effect lasts as long as therapeutic concentrations are maintained in the tissues, which is usually 8 to 12 hours after a dose. TXA does not affect standard coagulation tests like Prothrombin Time (PT) or Activated Partial Thromboplastin Time (aPTT) at therapeutic concentrations.
| Parameter | Value |
|---|---|
Common questions about Tranexamic Acid In Sodium Chloride
Tranexamic Acid is primarily used to treat and prevent excessive bleeding in various medical situations. Its most common FDA-approved uses include treating heavy menstrual bleeding (menorrhagia) and preventing hemorrhage in patients with hemophilia during dental work. Additionally, it is used 'off-label' in emergency medicine for trauma-related bleeding and in surgery to reduce the need for blood transfusions. By stabilizing blood clots, it helps the body retain its natural defenses against blood loss. It is not a hormone and does not stop a period entirely, but rather reduces the volume of flow.
The most frequently reported side effects of Tranexamic Acid are generally mild and include headaches, sinus congestion, and back or joint pain. Some patients also experience abdominal discomfort or muscle cramps during the days they take the medication. Nausea and diarrhea can occur, particularly if the medication is taken on an empty stomach. While these symptoms are common, they usually resolve quickly once the 5-day treatment cycle for heavy periods is completed. If side effects become severe or persistent, patients should contact their healthcare provider for guidance.
There is no known direct chemical interaction between Tranexamic Acid and alcohol that would make the combination toxic. However, alcohol can have a mild blood-thinning effect and may cause blood vessels to dilate, which could potentially worsen the bleeding condition you are trying to treat. Furthermore, both alcohol and Tranexamic Acid can cause dizziness or stomach upset, and combining them may increase the severity of these side effects. It is generally recommended to avoid or significantly limit alcohol consumption while being treated for a bleeding disorder. Always check with your doctor regarding your specific health status and alcohol use.
Tranexamic Acid is considered a Pregnancy Category B medication, meaning animal studies have not shown harm to the fetus, but there are limited controlled studies in pregnant women. It is frequently used in life-threatening situations like postpartum hemorrhage, where its benefits in saving the mother's life are well-established. However, for non-emergency use during pregnancy, it should only be administered if the potential benefit justifies the potential risk. It does cross the placenta and enters fetal circulation. Pregnant women should always have a detailed discussion with their obstetrician before using this or any medication.
The onset of action for Tranexamic Acid depends on how it is administered. When given intravenously in a hospital or surgical setting, it begins working almost immediately to stabilize blood clots. For the oral treatment of heavy menstrual periods, patients usually notice a significant reduction in blood flow within the first 24 hours of starting the medication. Most women see the full benefit during the first menstrual cycle in which they use the drug. If you do not see a reduction in bleeding after two cycles of use, you should consult your doctor to explore other potential causes for your heavy flow.
Yes, Tranexamic Acid can be stopped suddenly without the need for a tapering period. Since it is typically used intermittently (such as for the first 5 days of a menstrual period or as a one-time dose during surgery), the body does not develop a physical dependence on the medication. There are no known withdrawal symptoms associated with stopping the drug. However, once you stop taking it, the antifibrinolytic effect will wear off within about 24 hours, and your body's natural blood-clotting balance will return to its baseline state. Always follow the specific duration of treatment prescribed by your doctor.
If you miss a dose of Tranexamic Acid, you should take it as soon as you remember. If it is almost time for your next scheduled dose, skip the missed dose and return to your regular dosing schedule. It is important not to take two doses at the same time to make up for a missed one, as this can increase your risk of developing a blood clot. Consistently missing doses may reduce the effectiveness of the medication in controlling your bleeding. If you find it difficult to remember your doses, consider using a pill reminder app or a daily organizer.
Weight gain is not a recognized or common side effect of Tranexamic Acid. Clinical trials and post-marketing surveillance have not shown a link between the use of this medication and changes in body weight. Because Tranexamic Acid is typically taken for only a few days a month for heavy periods, it does not have the long-term metabolic or hormonal effects that usually lead to weight gain. If you experience sudden or unexplained weight gain while taking this medication, it may be related to other factors, such as hormonal changes or fluid retention, and should be discussed with your healthcare provider.
Tranexamic Acid can interact with several other medications, most notably hormonal contraceptives like birth control pills, patches, or rings. Taking these together significantly increases the risk of dangerous blood clots, such as deep vein thrombosis or stroke. It also interacts with other 'clot-promoting' drugs like Factor IX complex or anti-inhibitor coagulant complexes. While it can often be taken with common pain relievers like Tylenol, you should always provide your doctor with a full list of your current medications, including herbal supplements, to ensure there are no dangerous interactions. Pharmacists are also excellent resources for checking for drug-drug compatibility.
Yes, Tranexamic Acid is available as a generic medication in both tablet and injectable forms. The generic versions are bioequivalent to the brand-name versions, such as Lysteda (tablets) or Cyklokapron (injection), meaning they work the same way in the body. Generic Tranexamic Acid is typically much more affordable than the brand-name alternatives and is covered by most insurance plans. When your doctor writes a prescription, you can ask if a generic version is available to help reduce your out-of-pocket costs. Both the generic and brand-name versions require a prescription from a licensed healthcare provider.
Other drugs with the same active ingredient (Tranexamic Acid)
> Warning: Stop taking Tranexamic Acid and call your doctor immediately if you experience any of these serious symptoms.
Tranexamic Acid is generally intended for short-term or intermittent use. Data on continuous, long-term use (years) is limited. The primary concern with prolonged use is the potential for cumulative effects on the retina. Patients who require long-term therapy (e.g., for hereditary angioedema or chronic bleeding disorders) should undergo regular ophthalmological examinations, including visual acuity, color vision, and dilated fundus exams.
No FDA black box warnings currently exist for Tranexamic Acid. However, the FDA-approved labeling for Lysteda (oral TXA) contains a strong warning regarding the risk of blood clots, particularly when used in combination with hormonal contraceptives. The risk is significantly elevated in women who are obese or who smoke, especially those over the age of 35.
Report any unusual symptoms to your healthcare provider. Even mild side effects should be discussed if they become bothersome or persist beyond the duration of treatment.
Tranexamic Acid can inhibit GABA receptors in the central nervous system, which may lower the seizure threshold. This is primarily a concern with high-dose intravenous administration during complex surgeries (like open-heart surgery). Patients with a known history of epilepsy or seizures should be monitored closely.
While rare, severe hypersensitivity reactions, including anaphylaxis, have occurred. Patients with a known allergy to Tranexamic Acid or any of its inactive ingredients must avoid the drug entirely.
Depending on the duration of use, healthcare providers may require several monitoring tests:
Tranexamic Acid can occasionally cause dizziness or visual changes. Patients should observe how the medication affects them before driving or operating heavy machinery. If blurred vision or lightheadedness occurs, these activities should be avoided.
There is no direct chemical interaction between alcohol and Tranexamic Acid. However, alcohol can act as a mild blood thinner and may worsen the underlying bleeding condition for which TXA was prescribed. Additionally, combining alcohol with TXA may increase the risk of dizziness or gastrointestinal upset. It is generally advised to limit alcohol consumption during treatment.
For the treatment of heavy periods, Tranexamic Acid is stopped abruptly at the end of the 5-day cycle; there is no need for tapering. In surgical or trauma settings, the drug is typically used for a very short duration (24-48 hours). There is no known withdrawal syndrome associated with the cessation of Tranexamic Acid.
> Important: Discuss all your medical conditions with your healthcare provider before starting Tranexamic Acid, especially if you have a history of blood clots, kidney disease, or vision problems.
Drugs like ibuprofen (Advil, Motrin) or naproxen (Aleve) are often used to treat menstrual cramps. While there is no direct contraindication, both NSAIDs and TXA are used for menorrhagia. Some evidence suggests they can be used together, but the risk of gastrointestinal irritation may increase. Always consult a provider before combining these.
Thrombolytic drugs like alteplase, used to dissolve clots during a stroke or heart attack, work in the exact opposite way of Tranexamic Acid. TXA will neutralize the effect of these 'clot-busters.' If a patient on TXA requires emergency thrombolysis, the TXA may reduce the efficacy of the life-saving treatment.
There are no known significant interactions between Tranexamic Acid and specific foods. High-fat meals do not significantly alter the absorption of the oral tablets. Unlike some other medications, grapefruit and its juice do not affect the metabolism of TXA.
Patients should be cautious with supplements that have 'antiplatelet' or 'anticoagulant' properties, as they may counteract the goal of TXA therapy:
Tranexamic Acid does not typically interfere with standard blood chemistry or hematology tests. However, it may affect the results of specialized 'clot lysis' assays or fibrinolysis tests, as its presence in the blood will artificially prolong the time it takes for a sample to dissolve in a lab setting.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A complete list helps your pharmacist and doctor prevent dangerous interactions.
These conditions require a careful risk-benefit analysis by a physician:
There is no known cross-sensitivity between Tranexamic Acid and other common drug classes like penicillins, sulfonamides, or NSAIDs. However, patients who have had reactions to other antifibrinolytics, such as Aminocaproic Acid, should be treated with caution.
> Important: Your healthcare provider will evaluate your complete medical history, including your family history of blood clots, before prescribing Tranexamic Acid.
Clinical studies of Tranexamic Acid did not include sufficient numbers of subjects aged 65 and over to determine if they respond differently than younger subjects. However, because elderly patients are more likely to have decreased renal function, dose selection should be cautious, and renal function monitoring is essential. The risk of blood clots is also naturally higher in this age group.
For patients with a GFR (Glomerular Filtration Rate) below 50 mL/min, Tranexamic Acid is not recommended for the treatment of heavy periods. In surgical settings, the dose must be reduced by 50% to 75% depending on the severity of the kidney disease. Failure to adjust the dose can lead to visual disturbances and seizures.
No specific adjustments are needed for patients with liver disease, though these patients often have complex 'coagulopathies' (clotting disorders) that require a hematologist's oversight when using antifibrinolytic therapy.
> Important: Special populations require individualized medical assessment to ensure the benefits of bleeding control outweigh the potential risks.
| Protein Binding | < 3% (Primarily to plasminogen) |
| Half-life | 2 to 11 hours (Renal dependent) |
| Tmax | ~3 hours (Oral) |
| Metabolism | Minimal (< 5% Hepatic) |
| Excretion | Renal (> 95% unchanged) |
Tranexamic Acid is an Antifibrinolytic Agent. It is more potent than its predecessor, Aminocaproic Acid (Amicar). While both drugs work similarly, Tranexamic Acid's stronger binding affinity for plasminogen allows for lower dosing and a more favorable side-effect profile in many clinical settings.