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:
- liquid – for children and people who cannot swallow tablets
- 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.
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.
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.
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.
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.
Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.
9. Common questions
How does it work?
Tranexamic acid helps your body's natural blood-clotting process. Blood clots play an important part in stopping bleeding.
Blood clots are formed by a protein called fibrin. However, there are enzymes in your body that break down fibrin, meaning blood clots may not stay in place. This is called "fibrinolysis".
Tranexamic acid is a type of medicine called an anti-fibrinolytic. It helps prevent fibrinolysis by stopping the fibrin from being broken down. This helps blood clots stay in place where they are needed.
How long does it take to work?
The length of time for tranexamic acid to work varies. It can take up to 24 hours for the medicine to take full effect.
How long will I take it for?
Tranexamic acid is usually used for a short time to treat bleeding. Usually you will take this medicine for 4 days for heavy periods, or for 7 days to treat other bleeding that does not stop by itself.
People who have a condition such as hereditary angioedema may need to take it for a short time over several months or years.
Can I take it for a long time?
People with regular nose bleeds or heavy periods can take tranexamic acid long term, over several months or years. However, they usually take it just for a few days or a week at a time when the bleeding is a problem.
Are there similar medicines to tranexamic acid?
There are other medicines that are used to stop bleeding. However, they do not work in the same way as tranexamic acid.
Etamsylate can be prescribed for heavy periods, but it may not work as well as tranexamic acid.
Can tranexamic acid be used for other conditions?
Tranexamic acid has been tested to treat skin discolouration in people with hyperpigmentation (melasma).
However it's too early to know how well this works as a skin lightening treatment for hyperpigmentation. More research is needed before it can be recommended.
Can I drink alcohol with it?
Yes, you can drink alcohol while taking tranexamic acid
Is there any food or drink I should avoid?
You can eat and drink normally while taking tranexamic acid.
Will it affect my contraception?
Tranexamic acid does not affect any type of contraception, including the combined pill or emergency contraception. However, talk to your doctor if you’re taking the pill. There may be a very small increased risk of having a thrombosis (a blood clot inside a vein) if you also take tranexamic acid.
If tranexamic acid makes you vomit or have severe diarrhoea for more than 24 hours (this is more likely if you have tranexamic acid injections), your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.
Will it affect my fertility?
There's no firm evidence to suggest that taking tranexamic acid will reduce fertility in either men or women.
Can I drive or ride a bike?
Taking tranexamic acid will not affect your ability to drive a car or ride a bike.