From the Guidelines
The dose of Tranexamic acid (TXA) for uterine bleeding is 1 g intravenously.
Dosage Regimen
- The initial dose is 1 g (100 mg/mL) intravenously at 1 mL/min, given over 10 minutes 1.
- A second dose of 1 g intravenously may be given if bleeding continues after 30 minutes, or if bleeding restarts within 24 hours of completing the first dose 1.
Indications
- 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 for treatment of post-partum haemorrhage if the bleeding is severe (> 500 ml after a vaginal delivery and > 1000 ml after a caesarean delivery) 1.
Timing
- TXA should be given within 3 hours of birth 1.
- A second dose may be given 0.5-23.5 hours later if bleeding persists 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, a dose of 3.9 g/d for up to 5 days per menstrual cycle has been used in clinical trials 2.
- In the management of dysfunctional uterine bleeding, a dose of 2 g/day has been shown to be effective and safe 3.
- For post-partum haemorrhage, the WHO recommends a dose of 1 g 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 4, 5.
- In some studies, a dose of 1 g orally three times a day has been used to reduce menstrual blood loss in women with dysfunctional uterine bleeding 6.
Administration Routes
- Tranexamic acid can be administered orally or intravenously, depending on the specific condition being treated and the severity of the bleeding.
- For post-partum haemorrhage, intravenous administration is recommended due to its rapid onset of action 4, 5.
- For heavy menstrual bleeding and dysfunctional uterine bleeding, oral administration is commonly used 2, 3, 6.