From the Guidelines
The dose of Tranexamic acid (TXA) for uterine bleeding is 1 g intravenously.
Dosage Details
- The dose can be repeated if bleeding continues after 30 minutes, or if bleeding restarts within 24 hours of completing the first dose, with a second dose of 1 g intravenously 1.
- The recommended administration is at a fixed dose of 1 g (100 mg/mL) intravenously at 1 mL/min, given over 10 minutes 1.
Clinical Context
- TXA should be given in all cases of post-partum haemorrhage, regardless of whether the bleeding is thought to be due to genital tract trauma or for other reasons, including uterine atony 1.
- The use of TXA is recommended within 3 hours of birth, in addition to standard care for women with clinically diagnosed post-partum haemorrhage following vaginal birth or caesarean section 1.
- A clinically estimated blood loss of more than 500 mL after vaginal birth or 1000 mL after caesarean section, or any blood loss that is sufficient to compromise haemodynamic stability, is considered a clinically diagnosed post-partum haemorrhage 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Dose of Tranexamic Acid for Uterine Bleeding
The dose of tranexamic acid (TXA) for uterine bleeding varies depending on the specific condition being treated.
- For heavy menstrual bleeding, the recommended oral dosage is 3.9-4 g/day for 4-5 days starting from the first day of the menstrual cycle 2.
- For postpartum hemorrhage, the WHO recommends 1 g of tranexamic acid intravenously as soon as possible after giving birth, followed by a second dose if bleeding continues after 30 minutes or restarts within 24 hours since the first dose 3.
- A study on the optimal use of intravenous tranexamic acid for hemorrhage prevention in pregnant women proposed an optimal dose of 600 mg in future tranexamic acid efficacy studies to prevent postpartum hemorrhage 4.
Administration Routes and Timing
- Tranexamic acid can be administered orally or intravenously, depending on the condition being treated.
- For postpartum hemorrhage, intravenous administration is recommended as soon as possible after giving birth 3.
- The timing of administration is critical, as tranexamic acid is most effective when given early, ideally within 3 hours of childbirth 3.
Safety and Efficacy
- Tranexamic acid has been shown to be effective in reducing bleeding-related mortality in women with postpartum hemorrhage 5, 3.
- The safety profile of tranexamic acid is generally good, with few adverse effects reported 2, 4.
- However, tranexamic acid is contraindicated in women with active thromboembolic disease or a history of thrombosis or thromboembolism 2.