TXA

Tranexamic acid (TXA) is a synthetic derivative of the amino acid lysine that acts as an antifibrinolytic agent. It works by competitively inhibiting plasminogen activation and plasmin activity, thereby reducing the breakdown of fibrin clots and helping to stabilize hemostasis.

TXA is used to reduce bleeding in a variety of clinical contexts. These include major surgical procedures such as orthopedic and cardiac surgery, trauma with significant bleeding, obstetric hemorrhage, and gynecologic bleeding such as menorrhagia. It is also employed in dental and oral surgery to limit bleeding, and in some cases given systemically for broader hemostatic effect or used topically as a rinse or gel.

The drug is available in multiple formulations, including oral tablets, intravenous solutions, and topical preparations for local hemostasis. It is rapidly absorbed and predominantly cleared by the kidneys, so dose adjustments may be needed in patients with renal impairment. The choice of route and dosing depends on the indication and patient factors.

Contraindications include active intravascular clotting and a history of thromboembolic disease, as well as hypersensitivity to tranexamic acid. Caution is advised in patients with renal impairment, pregnancy, or a predisposition to seizures, especially at higher intravenous doses. Common adverse effects are generally mild and can include nausea, vomiting, diarrhea, headache, dizziness, or injection-site reactions; more serious but rare risks include thromboembolic events and hypersensitivity reactions.

Overall, TXA is a widely used hemostatic agent whose benefits in reducing bleeding must be weighed against potential thromboembolic risks in individual patients.