Tranexamic acid


1. About

Tranexamic acid (sometimes shortened to txa) is a medicine that controls bleeding. It helps your blood to clot and is used for nosebleeds and heavy periods.

If you're having a tooth taken out, using tranexamic acid mouthwash can help stop bleeding.

Tranexamic acid can also help if you have a condition that causes swelling under the skin (hereditary angioedema).

If you have any condition that causes you to bleed more than usual, you may need to take tranexamic acid for a few days before having surgery or dental surgery.

Tranexamic acid comes on prescription as:

  • tablets
  • liquid – for children and people who cannot swallow tablets
  • mouthwash
  • injections – usually only given in hospital

Tranexamic acid tablets for heavy periods are also available to buy from pharmacies, for adults aged 18 and above.


2. Key facts

  • You'll usually take tranexamic acid for a few days at a time.
  • You can take the tablets with or without food.
  • Most people do not have any side effects when taking tranexamic acid.
  • If you also take the combined contraceptive pill ("the pill"), there's an increased risk of DVT (deep vein thrombosis) with tranexamic acid.
  • Brand names include Cyklokapron, Cyklo-F and Menstralite.

3. Who can and cannot take tranexamic acid

Tranexamic acid can be prescribed for adults and children of all ages.

Tranexamic acid is not suitable for some people. To make sure tranexamic acid is safe for you, tell your doctor before taking this medicine if you:

  • have had an allergic reaction to tranexamic acid or any other medicine in the past
  • have ever had a DVT (deep vein thrombosis) or pulmonary embolism (blocked blood vessel in your lungs)
  • have had a coagulopathy (a rare condition where lots of small blood clots form in your blood followed by abnormal bleeding)
  • have epilepsy
  • have kidney problems
  • are pregnant or trying to get pregnant
  • have irregular periods – this is so your doctor can check what is causing the irregular bleeding and recommend the best treatment for you

4. How and when to take it

If you are prescribed tranexamic acid tablets, you can take them with or without food.

If you've been told to take the tablets 3 or 4 times a day, try to space the doses evenly throughout the day.

If your dentist has prescribed tranexamic mouthwash, this might come as a ready-made mouthwash or as a tablet that you mix with water. Follow the instructions that come with your medicine.

Dosage

Tranexamic acid comes as 500mg tablets. For adults the usual dose is 2 or 3 tablets, taken 3 times a day. Doses are usually lower for people with kidney problems.

The liquid comes in different strengths. Follow the instructions on the label to make sure you take the right dose.

If your child is prescribed tranexamic acid, the doctor will use your child's weight or age to work out the right dose.

Will my dose go up or down?

Most people taking tranexamic acid take 2 tablets (1,000mg), 3 times a day. If this is not working well enough to control your bleeding, your doctor may tell you to take 2 tablets 4 times day.

What if I forget to take a dose?

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.

What if I take too much?

Taking 1 extra dose of tranexamic acid by accident 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 dizziness. Speak to your doctor if you're worried or if these side effects are troubling you.

Urgent advice: Call 111 for advice if:

You've taken 2 extra doses of tranexamic acid (or more) and:

  • you get problems with your eyesight
  • one of your legs or arms is painful, swollen, red and warm to touch
  • you suddenly get shortness of breath, or a sharp pain in your chest, and start coughing or coughing up blood

5. Side effects

Like all medicines, tranexamic acid can cause side effects although not everyone gets them.

Common side effects

There are no common side effects with tranexamic acid tablets.

If you have an injection of tranexamic acid, you are more likely to have side effects. These include:

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Urgent advice: Call 111 now if:

  • you get problems with your eyesight
  • one of your legs or arms is painful, swollen, red and warm to touch
  • you suddenly get shortness of breath, or a sharp pain in your chest, and start coughing or coughing up blood

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to tranexamic acid.

Immediate action required: Call 999 or go to A&E now if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in your chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of tranexamic acid. For a full list, see the leaflet inside your medicines packet.

Information:

You can report any suspected side effect to the UK safety scheme.


6. How to cope with side effects

What to do about:

  • feeling sick (nausea) – if you feel sick after having the injection, it may help if you avoid rich or spicy food. If it carries on, or the effects are severe, tell your doctor. They may be able to prescribe an extra medicine to help with these symptoms.
  • diarrhoea – if you get diarrhoea after having the injection, drink plenty of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Tell your doctor or pharmacist if it carries on. Sometimes reducing the dose helps.
  • itchy red skin (where you had the injection) – apply a soothing cream such as a moisturiser, anti-itch cream or lotion. If the rash is dark red, gets worse or carries on for more than a few days, speak to your doctor.

7. Pregnancy and breastfeeding

Tranexamic acid is not usually recommended if you are pregnant. This is because there is not enough information to say whether it's safe. However, your doctor may prescribe it if they think the benefits of the medicine outweigh the risks.

If you're pregnant or trying for a baby, talk to your doctor about the benefits and possible risks of taking tranexamic acid.

Tranexamic acid and breastfeeding

Small amounts of tranexamic acid may get into breast milk. However, this medicine is generally considered safe for breastfeeding mothers and babies.

Talk to your doctor if you have any concerns about taking tranexamic acid while you're breastfeeding.

Non-urgent advice: Tell your doctor if:

  • you're trying to get pregnant
  • you're already pregnant
  • you're breastfeeding

8. Cautions with other medicines

Tranexamic acid can be taken with most other medicines.

However, talk to your doctor or pharmacist if you're taking the combined pill. There could be a very small increased risk of getting a blood clot if you take tranexamic acid as well.

Mixing tranexamic acid with herbal remedies or supplements

There is not enough research to say whether herbal remedies or supplements are safe to take with tranexamic acid. This is because they are not tested in the same way as prescription medicines.

Important

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.


9. Common questions

Page last reviewed: 17/01/2020
Next review due: 17/01/2023