What is the dose of oral tranexamic acid (TXA) for treating Subdural Hematoma (SDH)?

From the Research

The recommended dose of oral tranexamic acid (TXA) for treating Subdural Hematoma (SDH) is 750 mg daily, as supported by the most recent and highest quality study 1. However, it is essential to note that TXA is not routinely recommended as a standard treatment for SDH in clinical practice, and its use remains investigational. The management of SDH typically involves neurosurgical intervention or watchful waiting with serial imaging, along with addressing underlying causes like coagulopathy or anticoagulant use. Some studies, such as 2 and 3, have explored the use of TXA in chronic subdural hematoma, showing promising results with a dose of 750 mg daily. However, a more recent study 1 suggests that TXA may not be effective in reducing recurrence rates and might increase complication odds, which highlights the need for caution and further research. If considering TXA for SDH, consultation with a neurosurgeon or neurologist is crucial to evaluate the specific clinical situation and weigh potential benefits against risks of thrombotic complications. Key points to consider include:

• The lack of established standard dosing for TXA in SDH treatment
• The investigational nature of TXA use in SDH management
• The need for individualized evaluation and consultation with a specialist
• The potential risks and benefits of TXA treatment, as highlighted by studies such as 1 and 2.