From the Guidelines
The recommended dose of tranexamic acid (TXA) for treating dysfunctional uterine bleeding is typically 1,000-1,300 mg taken orally three to four times daily during menstruation, usually for up to 5 days. This dosage is based on the most recent and highest quality studies available, which prioritize minimizing morbidity, mortality, and improving quality of life for patients 1.
Key Considerations for TXA Treatment
- Treatment should begin when menstrual bleeding starts and continue until bleeding diminishes, generally not exceeding the 5-day period.
- For many patients, a common regimen is 1,300 mg three times daily.
- TXA works by inhibiting fibrinolysis, which helps stabilize blood clots and reduces heavy menstrual flow.
- This medication is most effective when taken at the onset of bleeding rather than waiting until bleeding becomes heavy.
Important Safety Information
- Patients should be aware that common side effects may include nausea, vomiting, and headache.
- TXA should be used with caution in patients with a history of thromboembolic disorders, as it could potentially increase clotting risk, though this risk is considered minimal at standard doses for menstrual bleeding.
- If bleeding remains uncontrolled despite TXA treatment, patients should seek medical attention promptly.
Evidence Base
The recommendation for the use of TXA in dysfunctional uterine bleeding is supported by studies that demonstrate its efficacy in reducing menstrual blood loss and improving quality of life for patients 1. While the exact dosage may vary depending on the patient's response and medical history, the general guideline of 1,000-1,300 mg three to four times daily is widely accepted and supported by clinical evidence.
From the Research
Recommended Dose of Tranexamic Acid
The recommended dose of tranexamic acid (TXA) for treating dysfunctional uterine bleeding varies across studies.
- A study published in 2012 2 recommends an oral dosage of 3.9-4 g/day for 4-5 days starting from the first day of the menstrual cycle.
- Another study from 2006 3 found that a dose of 2 g/day TXA is an effective and safe option for dysfunctional uterine bleeding.
- A 2009 study 4 used a dose of 500 mg of tranexamic acid three times a day during menses, with a response rate of 65.9%.
- An earlier study from 1996 5 used a dose of 1 g six hourly, which reduced menstrual blood loss by 54%.
Efficacy and Safety
Tranexamic acid has been shown to be an effective treatment for dysfunctional uterine bleeding, with significant reductions in menstrual blood loss and improvements in quality of life.
- The 2012 study 2 found that TXA reduces menstrual blood loss by 26%-60% and is significantly more effective than placebo and other medical treatments.
- The 2006 study 3 found that 2 g/day TXA reduced mean pictorial blood loss assessment chart (PBAC) score by 60.3% after 3 months.
- The 2009 study 4 found that oral tranexamic acid had a response rate of 66.0% in patients with excessive dysfunctional perimenopausal bleeding.
- The 1996 study 5 found that tranexamic acid reduced menstrual blood loss by 54% and was a safe and highly effective treatment for excessive bleeding.