Tranexamic Acid (TXA): What it Treats and How to Use It Safely

Want a quick, useful guide to tranexamic acid (TXA)? This medicine helps reduce bleeding in many situations — heavy periods, surgery, dental work, trauma, and postpartum hemorrhage. Below I’ll explain how it works, common doses you’ll see, and practical safety tips you can use when talking with your doctor or pharmacist.

How TXA works and when it's used

TXA is an antifibrinolytic. That means it helps blood clots stay put by blocking the breakdown of fibrin, the protein that stabilizes clots. Clinicians use it for heavy menstrual bleeding (menorrhagia), to lower bleeding during or after surgery, for serious trauma, and to control nosebleeds or dental bleeding in people with bleeding risks.

Big trials back its use: the CRASH-2 study showed TXA given early after major trauma reduced death from bleeding, and the WOMAN trial found it lowered deaths from postpartum hemorrhage when given quickly. Those two trials are why TXA is now common in emergency and obstetric care.

Doses people actually get, side effects, and safety tips

Here are common dosing patterns you’ll see — always follow a prescriber’s instructions:

• Oral for heavy periods: commonly 1 g three times daily during bleeding days (some protocols use 500 mg TID). Treatment usually covers the heavy days only (about 3–5 days).
• IV for trauma (CRASH-2): 1 g IV over 10 minutes, then 1 g infusion over 8 hours.
• Surgery prophylaxis: many teams use 10–15 mg/kg IV before incision or a flat 1 g dose; dosing varies by procedure and team preference.
• Obstetric bleeding (WOMAN): 1 g IV as soon as possible, may repeat once if bleeding continues.

Common side effects are mild: nausea, diarrhea, and dizziness. Important warnings: TXA can raise the risk of clotting in people who already have active thromboembolic disease (deep vein thrombosis, pulmonary embolism) or known clotting disorders. In high doses—especially in some cardiac surgery settings—there’s a higher risk of seizures.

Kidney clears TXA, so doses need lowering if kidney function is poor. Also tell your clinician about hormonal birth control or estrogen therapy; both increase clot risk, so the team will weigh benefits and risks together. Pregnant people may receive TXA in postpartum hemorrhage settings; it’s commonly used in emergencies under clinician guidance.

Practical tips: bring a list of meds and health problems when TXA is likely to be used; ask if dose adjustment is needed for kidney disease; if you have a history of clots, raise that flag early. If TXA is prescribed for menstrual bleeding, use it only on heavy-flow days and store it safely out of reach of children.

Want more specifics for your situation? Ask your prescriber for exact dosing and safety checks — TXA works well when used the right way and under medical supervision.