What is Tranexamic Acid (TXA)?
Tranexamic acid (TXA) is a life-saving medication that stops bleeding by preventing blood clots from breaking down, and should be given as early as possible (within 3 hours) to trauma patients who are bleeding or at risk of significant bleeding.
How TXA Works (Simple Explanation)
Imagine your body has a special system that both makes blood clots (to stop bleeding) and breaks them down (to prevent too many clots). TXA works like this:
- TXA is a synthetic medicine that looks like a building block of your body called lysine
- When you're bleeding, your body makes clots to plug the holes
- Your body also has a system that breaks down clots (called fibrinolysis)
- TXA blocks this breakdown system, helping clots stay in place longer
- This helps stop bleeding faster and prevents too much blood loss
When TXA is Used
TXA is used in several important situations:
- Trauma with bleeding: Given within 3 hours of injury 1
- Postpartum hemorrhage: For excessive bleeding after childbirth 1
- Surgical procedures: To reduce blood loss during operations
- Tooth extractions: For patients with bleeding disorders like hemophilia 2
- Heavy menstrual bleeding: To reduce monthly blood loss
How TXA is Given
For trauma patients:
- First dose: 1 gram given through an IV over 10 minutes
- Second dose: 1 gram given through an IV over 8 hours 1
- Timing: Must be given within 3 hours of injury (earlier is better) 1
Why TXA is Important
- Reduces death from bleeding: Can reduce death due to bleeding by about one-third when given early 3
- Works best when given quickly: Every 15-minute delay reduces benefit by 10% 1
- Safe for most patients: Has few serious side effects 3
- Cost-effective: Very inexpensive compared to other treatments 1
Important Things to Know About TXA
- Time matters: Must be given within 3 hours of injury - after that it may be harmful 1
- Don't wait for test results: Should be given immediately to bleeding patients without waiting for lab tests 1
- Pre-hospital use: Can be given by ambulance crews before reaching the hospital 1
- Wide application: Should be given to all bleeding trauma patients, not just those with severe injuries 1
Cautions When Using TXA
- Time limit: Should NOT be given after 3 hours from injury 1
- Contraindications: Should be avoided in patients with known blood clots 1
- Seizure risk: Higher doses may increase seizure risk in some patients 1
TXA is one of the most important emergency medications discovered in recent years, saving thousands of lives worldwide by helping control bleeding in trauma, childbirth, and surgery.