Tranexamic acid is an antifibrinolytic agent primarily used to reduce bleeding or prevent fibrin breakdown. It works by inhibiting the activity of plasmin, thereby prolonging the hemostatic effect after blood clot formation. Commonly used in surgical procedures, menorrhagia, or specific bleeding disorders.
The mechanism involves blocking the fibrinolytic process, making formed clots less susceptible to degradation. Therefore, it is suitable for medical situations requiring enhanced hemostasis. This medication can be administered orally or intravenously, 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 drug. It primarily acts on the later stages of the blood coagulation process, differing from anticoagulants or antiplatelet agents in mechanism.
This medication is mainly used for:
In special cases, it may be used to reduce nosebleeds or bleeding caused by certain cancer chemotherapies, but must 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. If unilateral limb swelling or difficulty breathing occurs, immediate medical attention is required. Allergic reactions like rash or urticaria also need prompt attention.
Contraindications: Patients with a history of thrombosis, arterial embolism, or severe hepatic or renal impairment should not use this medication. Pregnant women should use it only after medical evaluation, and breastfeeding women should avoid use or discontinue breastfeeding.
The black box warning indicates that this drug may induce retinal vascular occlusion, especially with high doses or long-term use. Sudden vision loss or blurring requires immediate discontinuation and retinal examination.
Concurrent use with anticoagulants (such as warfarin) may increase bleeding or thrombosis risk, requiring dose adjustments. Combining with non-steroidal anti-inflammatory drugs (NSAIDs) may increase gastrointestinal bleeding risk.
Avoid simultaneous use with antiplatelet agents (such as aspirin), as it may reduce efficacy or increase side effects. All concomitant medications and supplements should be disclosed to the healthcare provider prior to use.
Oral doses are typically 10-25 mg per kilogram of body weight, administered 2-3 times daily, taken with meals to reduce gastrointestinal discomfort. Intravenous injections should be performed by trained medical personnel, with speed and dosage adjusted based on the condition.
For uterine bleeding, high doses (such as a single dose of 10-15 mg/kg) may be used, while for menorrhagia, short-term cyclic use is common. Pediatric doses should be adjusted based on weight and age, and self-adjustment of medication is strictly prohibited.
If a dose is missed, it should be taken as soon as remembered. If it is close to the next scheduled dose, skip the missed dose and resume the regular schedule. Do not double doses to make up for missed ones, as this may increase side effect risk.
Overdose may lead to severe thrombosis or renal toxicity, with symptoms such as severe headache, confusion, or decreased urine output. Immediate medical attention and supportive treatments such as gastric lavage may be necessary.
If retinal hemorrhage or vision loss occurs, urgent ophthalmologic examination and antidote administration are required. Dialysis may be used by healthcare professionals to remove excess drug.
Tranexamic acid can be taken with or without food, but if gastrointestinal discomfort occurs, it is recommended to take it with meals to reduce stomach irritation. Avoid taking it with calcium-rich foods (such as cheese or milk), as calcium may affect drug absorption. Take the medication at a consistent time each day to maintain stable blood levels.
What should I do if abnormal bleeding occurs while using tranexamic acid?While tranexamic acid may increase thrombosis risk, if unexplained bleeding such as gum bleeding, sudden increase in menstrual flow, or hematuria occurs, stop the medication and seek medical attention immediately. Mild headaches or nausea are usually short-term side effects, but persistent discomfort should be reported to a doctor. The physician may adjust the dose or recommend other hemostatic measures.
What are the risks of combining tranexamic acid with anticoagulants (such as warfarin)?Using tranexamic acid with anticoagulants may reduce anticoagulant efficacy and increase thrombosis risk. If combined, blood coagulation parameters (such as 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 herbal supplements.
Should tranexamic acid be discontinued before surgery or dental treatment?When planning surgery or invasive procedures, inform the healthcare provider 3-7 days in advance about ongoing tranexamic acid use. The physician may temporarily stop the medication to reduce bleeding or thrombotic complications during the procedure. Resumption of therapy should be based on postoperative recovery and reassessment of dosage.
Does long-term use of tranexamic acid cause liver or kidney dysfunction?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 serum creatinine. Immediate discontinuation and medical evaluation are necessary if jaundice, dark urine, or lower limb edema occur.
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