What does tranexamic acid do?

Tranexamic acid is an antifibrinolytic medication. It helps prevent bleeding by stopping the body from breaking down clots that have formed.

Key points:
- How it works: It blocks the enzymes involved in breaking down clots (plasminogen/plasmin) by binding to lysine-binding sites, so clots stay intact longer.
- What it’s used for:
- Heavy menstrual bleeding (menorrhagia)
- Reducing bleeding during dental work in people with bleeding disorders or who are at risk
- Nosebleeds (epistaxis) and some surgical settings to lessen blood loss
- Postpartum hemorrhage in some guidelines (as an adjunct)
- Other situations where preventing excessive bleeding is important (your clinician will decide)

Forms and typical dosing (examples; exact dose depends on condition and patient factors):
- Oral tablets (e.g., 500 mg): commonly 1 g two to three times daily for several days for heavy menstrual bleeding; some regimens use 1 g three times daily for up to 5–7 days.
- Oral regimens for dental procedures in at-risk patients: about 25 mg/kg three times daily for several days (dosage adjusted to the patient).
- Topical or local use (mouthwash, nasal sprays) can be used for localized bleeding (as directed by a clinician).

Common side effects:
- Nausea, vomiting, diarrhea, upset stomach
- Headache
- Rarely: allergic reactions or visual disturbances

Important safety notes:
- There is a risk of blood clots forming elsewhere in the body (thrombosis) in some people.
- Use with caution if you have a history of thrombosis, stroke, heart attack, or significant kidney disease (dose adjustments may be needed).
- It can lower the seizure threshold at high IV doses, especially in people with kidney problems.
- Pregnancy and breastfeeding: talk to a clinician about benefits and risks in your specific situation.
- Interactions: avoid or use with caution with other agents that affect blood clotting; tell your clinician if you’re taking anticoagulants (like warfarin or DOACs).

If you have a specific use (for example, heavy menstrual bleeding, a dental procedure, or a postpartum situation) or are considering taking this medication, tell me your condition and any health issues, and I can tailor the information and potential dosing. If you’re currently prescribed tranexamic acid, follow your clinician’s exact instructions and contact them with any concerns or side effects.