Tranexamic acid (TXA) is a medication used to treat or prevent excessive blood loss from major trauma, postpartum bleeding, surgery, tooth removal, nosebleeds, and heavy menstruation. It is also used for hereditary angioedema. It is taken either orally or by injection into a vein. Tranexamic acid is a synthetic analog of the amino acid lysine. It serves as an antifibrinolytic by reversibly binding four to five lysine receptor sites on plasminogen. This decreases the conversion of plasminogen to plasmin, preventing fibrin degradation and preserving the framework of fibrin's matrix structure. Tranexamic acid has roughly eight times the antifibrinolytic activity of an older analogue, ε-aminocaproic acid. Tranexamic acid also directly inhibits the activity of plasmin with weak potency (IC50 = 87 mM), and it can block the active-site of urokinase plasminogen activator (uPA) with high specificity (Ki = 2 mM), one of the highest among all the serine proteases. Side effects are rare. Some include changes in color vision, blood clots, and allergic reactions. Greater caution is recommended in people with kidney disease. Tranexamic acid appears to be safe for use during pregnancy and breastfeeding. Tranexamic acid is an antifibrinolytic medication. Tranexamic acid was first made in 1962 by Japanese researchers Shosuke and Utako Okamoto. It is on the World Health Organization's List of Essential Medicines. Tranexamic acid is available as a generic drug. Tranexamic acid is frequently used following major trauma. Tranexamic acid is used to prevent and treat blood loss in a variety of situations, such as dental procedures, heavy menstrual bleeding, and surgeries with high risk of blood loss. Tranexamic acid has been found to decrease the risk of death due to any cause in people who have significant bleeding due to trauma. It is most effective if taken within the first three hours following major trauma. It also decreases the risk of death if given within the first three hours of brain injury. Tranexamic acid is sometimes used to treat heavy menstrual bleeding.
Nikolaos Stergiopoulos, Augusto Martins Lima
Patrick Aebischer, Jeffrey Alan Hubbell