From the Research
Tranexamic acid (TXA) helps with edema by inhibiting the breakdown of blood clots, which reduces bleeding and subsequent fluid accumulation in tissues. TXA works as an antifibrinolytic agent that blocks the conversion of plasminogen to plasmin, preventing the dissolution of fibrin clots. When tissue injury occurs, blood vessels leak fluid into surrounding tissues causing swelling. By stabilizing clots and reducing vascular permeability, TXA limits this fluid extravasation. The mechanism of action of TXA is supported by a study published in 2021 1, which found that TXA is not associated with an increased risk of thromboembolic events. Some key points to consider when using TXA for edema include:
- The typical dosage for TXA varies by indication, but commonly ranges from 10-25 mg/kg intravenously or 1-1.5 grams orally three times daily.
- For post-surgical or traumatic edema, TXA is often administered before or during procedures and may be continued for 24-72 hours afterward.
- Side effects can include nausea, vomiting, and rarely, thromboembolic events.
- TXA is particularly effective for edema associated with bleeding disorders, surgical procedures, or trauma, but should be used cautiously in patients with a history of thrombosis or renal impairment as it is primarily excreted by the kidneys. A study published in 2018 2 found that topical TXA is effective in reducing blood loss and transfusion requirements, without increasing the risk of thromboembolic events. Another study published in 2021 3 reviewed the evidence around common controversies surrounding TXA, including the risk of thrombosis, and found that TXA is safe and effective when used appropriately. Overall, the use of TXA for edema is supported by a strong evidence base, and it should be considered as a treatment option for patients with bleeding disorders, surgical procedures, or trauma.