Tranexamic acid (TXA) is an antifibrinolytic agent that works by inhibiting plasminogen activation and plasmin activity, thereby reducing fibrinolysis and stabilizing blood clots. Its pharmacological actions include:
Inhibition of Plasminogen Activation – Tranexamic acid binds to lysine-binding sites on plasminogen, preventing its conversion to plasmin, the enzyme responsible for breaking down fibrin clots.
Reduction of Fibrinolysis – By blocking plasmin activity, Tranexamic acid prevents the premature breakdown of blood clots, helping to control excessive bleeding.
Hemostatic Effect – Tranexamic acid is commonly used in conditions involving excessive bleeding, such as surgery, trauma, heavy menstrual bleeding, and hemophilia-related bleeding.
Anti-inflammatory Properties – Tranexamic acid has been shown to reduce inflammation by inhibiting plasmin-mediated inflammatory processes.
Clinical Uses:
- Postoperative bleeding (e.g., cardiac, orthopedic, dental surgeries)
- Trauma-related hemorrhage
- Heavy menstrual bleeding (menorrhagia)
- Hereditary angioedema
- Epistaxis (nosebleeds)
- Postpartum hemorrhage
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Adverse effects of Tranexamic Acid
Tranexamic acid (TXA) is an antifibrinolytic medication used to prevent or treat excessive bleeding. While generally well-tolerated, it can have adverse effects, including:
Common Side Effects
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Headache
Serious but Rare Side Effects
- Thromboembolic events (e.g., deep vein thrombosis, pulmonary embolism, stroke) – Tranexamic acid inhibits fibrinolysis, which may increase clotting risk, especially in predisposed individuals.
- Seizures – More commonly reported with high doses, particularly in post-surgical settings.
- Hypotension – When given as a rapid IV injection.
- Visual disturbances – Rare but includes impaired color vision and other visual abnormalities.
Contraindications & Caution
- History of thromboembolic disorders (e.g., DVT, stroke)
- Renal impairment (Tranexamic acid is renally excreted, so dose adjustment may be needed)
- Subarachnoid hemorrhage (risk of cerebral vasospasm and ischemia)
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