Tranexamic acid

Medical uses 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. Trauma 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. Menstrual bleeding Tranexamic acid is sometimes used to treat heavy menstrual bleeding. Another study demonstrated that the dose does not need to be adjusted in females who are between ages 12 and 16. Childbirth Tranexamic acid is sometimes used (often in conjunction with oxytocin) to reduce bleeding after childbirth. Death due to postpartum bleeding is reduced in women receiving tranexamic acid. • In surgical corrections of craniosynostosis in children it reduces the need for blood transfusions. • In spinal surgery (e.g., scoliosis), correction with posterior spinal fusion using instrumentation, to prevent excessive blood loss. • In cardiac surgery, both with and without cardiopulmonary bypass (e.g., coronary artery bypass surgery), it is used to prevent excessive blood loss. Tranexamic acid is used for a short period before and after the surgery to prevent major blood loss and decrease the need for blood transfusions. Tranexamic acid is used in dentistry in the form of a 5% mouth rinse after extractions or surgery in patients with prolonged bleeding time; e.g., from acquired or inherited disorders. In China, tranexamic acid is allowed in over-the-counter toothpaste, with six products using the drug. , there are no limits on dosage, nor requirements for labeling the concentration. 0.05% TXA in toothpaste is allowed OTC in Hong Kong. <5% TXA in over-the-counter toothpaste is first patented and marketed by Lion Corporation in Japan, where it is still sold. Presence of unauthorized TXA has led to the Canadian recall of a Yunnan Baiyao toothpaste in 2019. Hematology There is not enough evidence to support the routine use of tranexamic acid to prevent bleeding in people with blood cancers. However, several trials are currently assessing this use of tranexamic acid. It has also been recommended for people with acquired bleeding disorders (e.g., directly acting oral anticoagulants (DOACs)) to treat serious bleeding. Nosebleeds The use of tranexamic acid, applied directly to the area that is bleeding or taken by mouth, appears useful to treat nose bleeding compared to packing the nose with cotton pledgets alone. It decreases the risk of rebleeding within 10 days. Cosmetic uses Tranexamic acid can be used in skincare products as a cosmetic active to reduce the appearance of inflammation and hyperpigmentation. Tranexamic acid is a zwitterion amino acid, and has a low permeability coefficient in the stratum corneum. Tranexamic acid can be combined with penetration enhancers and microneedling to overcome this limitation. Cosmetic uses may also employ lipophilic derivatives of tranexamic acid (ester prodrugs like Cetyl tranexamate mesylate) that are not zwitterionic and thus have improved skin permeability. ==Contraindications==

• Allergic to tranexamic acid • History of seizures • History of venous or arterial thromboembolism or active thromboembolic disease • Severe kidney impairment due to accumulation of the medication, dose adjustment is required in mild or moderate kidney impairment ==Adverse effects==

Side effects are rare. and they were reported in post marketing experience. even in people who had previously experienced thrombosis under other circumstances. ==Society and culture==

Tranexamic acid was first synthesized in 1962 by Japanese researchers Shosuke and Utako Okamoto. and Jordan it is marketed in an IV form and tablet form as Cyklokapron, in the UK and Sweden In March 2011, the status of tranexamic acid for the treatment of heavy menstrual bleeding was changed in the UK, from POM (Prescription only Medicines) to P (Pharmacy Medicines) and became available over the counter in UK pharmacies under the brand names of Cyklo-F and Femstrual. Research Tranexamic acid might alleviate neuroinflammation in some experimental settings. Tranexamic acid can be used in case of postpartum hemorrhage; it can decrease the risk of death due to bleeding by one third according to the WHO. Tentative evidence supports the use of tranexamic acid in hemoptysis. In hereditary angioedema In hereditary hemorrhagic telangiectasia: tranexamic acid has been shown to reduce the frequency of epistaxis in patients with severe and frequent nosebleed episodes from hereditary hemorrhagic telangiectasia. In melasma: tranexamic acid is sometimes used in skin whitening as a topical agent, injected into a lesion, or taken by mouth, both alone and as an adjunct to laser therapy; as of 2017 its safety seemed reasonable but its efficacy for this purpose was uncertain because there had been no large scale randomized controlled studies nor long term follow-up studies. It is allowed as a quasi-drug for skin whitening in Japan. In hyphema: tranexamic acid is effective in reducing the risk of secondary hemorrhage outcomes in people with traumatic hyphema. In liver resection: tranexamic acid did not reduce bleeding or transfusions but did increase complications. ==References==