What is the recommended oral (PO) dosing for tranexamic acid (TXA)?

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Last updated: July 4, 2025View editorial policy

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From the Research

The recommended oral dosing for tranexamic acid (TXA) is 3.9-4 g/day for 4-5 days starting from the first day of the menstrual cycle. This dosing regimen is based on the study by 1, which found that tranexamic acid significantly improves the quality of life of women treated for heavy menstrual bleeding. The study also notes that adverse effects are few and mainly mild, with no evidence of an increase in the incidence of thrombotic events associated with its use.

Some key points to consider when prescribing tranexamic acid include:

  • The medication should be taken orally, starting from the first day of the menstrual cycle
  • The duration of treatment is typically 4-5 days
  • Patients with a history of thromboembolism should use the medication cautiously, and it is contraindicated in those with active thromboembolic disease
  • Common side effects include nausea, vomiting, and diarrhea

It's worth noting that other studies, such as 2 and 3, have also investigated the use of tranexamic acid for heavy menstrual bleeding, but the study by 1 provides the most recent and highest quality evidence for the recommended dosing regimen. Additionally, studies like 4 and 5 have explored the use of tranexamic acid in different patient populations and formulations, but the dosing regimen recommended by 1 remains the most relevant and effective for the treatment of heavy menstrual bleeding.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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