Tranexamic acid

Last updated

Tranexamic acid
Tranexam.svg
Clinical data
Pronunciation\ˌtran-eks-ˌam-ik-\
Trade names Cyklokapron, others
Other namesTXA
AHFS/Drugs.com Monograph
MedlinePlus a612021
License data
Routes of
administration 		By mouth, intravenous, topical
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability 34%
Elimination half-life 3.1 h
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard (EPA)
ECHA InfoCard 100.013.471 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C8H15NO2
Molar mass 157.213 g·mol−1
3D model (JSmol)
  • NC[C@@H]1CC[C@H](CC1)C(O)=O
  • InChI=1S/C8H15NO2/c9-5-6-1-3-7(4-2-6)8(10)11/h6-7H,1-5,9H2,(H,10,11)/t6-,7- Yes check.svgY
  • Key:GYDJEQRTZSCIOI-LJGSYFOKSA-N Yes check.svgY
   (verify)

Tranexamic acid is a medication used to treat or prevent excessive blood loss from major trauma, postpartum bleeding, surgery, tooth removal, nosebleeds, and heavy menstruation. [6] [7] It is also used for hereditary angioedema. [6] [2] It is taken either by mouth, injection into a vein, [6] or by intramuscular injection.

Contents

Tranexamic acid is a synthetic analog of the amino acid lysine. It serves as an antifibrinolytic by reversibly binding four to five lysine receptor sites on plasminogen. This decreases the conversion of plasminogen to plasmin, preventing fibrin degradation and preserving the framework of fibrin's matrix structure. [4] Tranexamic acid has roughly eight times the antifibrinolytic activity of an older analogue, ε-aminocaproic acid.[ citation needed ] Tranexamic acid also directly inhibits the activity of plasmin with weak potency (IC50 = 87 mM), [8] and it can block the active-site of urokinase plasminogen activator (uPA) with high specificity (Ki = 2 mM), one of the highest among all the serine proteases. [9]

Side effects are rare. [2] Some include changes in color vision, seizures, blood clots, and allergic reactions. [2] Tranexamic acid appears to be safe for use during pregnancy and breastfeeding. [2] [10] Tranexamic acid is an antifibrinolytic medication. [11]

Tranexamic acid was first made in 1962 by Japanese researchers Shosuke and Utako Okamoto. [12] It is on the World Health Organization's List of Essential Medicines. [13] Tranexamic acid is available as a generic drug. [14]

Uses

Medical uses

A one-gram ampoule of tranexamic acid TXAVial2017.jpg
A one-gram ampoule of tranexamic acid

Tranexamic acid is frequently used following major trauma. [15] Tranexamic acid is used to prevent and treat blood loss in a variety of situations, such as dental procedures, heavy menstrual bleeding, and surgeries with high risk of blood loss. [16] [17]

Trauma

Tranexamic acid has been found to decrease the risk of death due to any cause in people who have significant bleeding due to trauma. [18] [19] [20] [21] It is most effective if taken within the first three hours following major trauma. [22] It also decreases the risk of death if given within the first three hours of brain injury. [23]

Menstrual bleeding

Tranexamic acid is sometimes used to treat heavy menstrual bleeding. [17] When taken by mouth it both safely and effectively treats regularly occurring heavy menstrual bleeding and improves quality of life. [4] [24] [25] Another study demonstrated that the dose does not need to be adjusted in females who are between ages 12 and 16. [4] In a 10-year study, tranexamic acid and other oral medicines (mefenamic acid) were found to be as effective as the levonorgestrel intrauterine coil; the same proportion of women had not had surgery for heavy bleeding and had similar improvements in their quality of life. [26] [27]

Childbirth

Tranexamic acid is sometimes used (often in conjunction with oxytocin) to reduce bleeding after childbirth. [28] Death due to postpartum bleeding is reduced in women receiving tranexamic acid. [7]

Surgery

  • Tranexamic acid is sometimes used in orthopedic surgery to reduce blood loss, to the extent of reducing or altogether abolishing the need for perioperative blood transfusion. It is of proven value in clearing the field of surgery and reducing blood loss when given before or after surgery. Drain and number of transfusions are reduced. [29] [30] [31]
  • In surgical corrections of craniosynostosis in children it reduces the need for blood transfusions. [32]
  • In spinal surgery (e.g., scoliosis), correction with posterior spinal fusion using instrumentation, to prevent excessive blood loss. [33] [34]
  • In cardiac surgery, both with and without cardiopulmonary bypass (e.g., coronary artery bypass surgery), it is used to prevent excessive blood loss. [29]

Dentistry

In the United States, tranexamic acid is FDA approved for short-term use in people with severe bleeding disorders who are about to have dental surgery. [35] Tranexamic acid is used for a short period of time before and after the surgery to prevent major blood loss and decrease the need for blood transfusions. [36]

Tranexamic acid is used in dentistry in the form of a 5% mouth rinse after extractions or surgery in patients with prolonged bleeding time; e.g., from acquired or inherited disorders. [37]

In China, tranexamic acid is allowed in over-the-counter toothpastes, with six products using the drug. As of 2018, there are no limits on dosage, nor requirements for labeling the concentration. [38] 0.05% TXA in toothpaste is allowed OTC in Hong Kong. [39] <5% TXA in over-the-counter toothpaste is first patented and marketed by Lion Corporation in Japan, [40] where it is still sold. [41] Presence of unauthorized TXA has led to the Canadian recall of a Yunnan Baiyao toothpaste in 2019. [42]

Hematology

There is not enough evidence to support the routine use of tranexamic acid to prevent bleeding in people with blood cancers. [43] However, there are several trials that are currently assessing this use of tranexamic acid. [43] For people with inherited bleeding disorders (e.g. von Willebrand's disease), tranexamic acid is often given. [44] It has also been recommended for people with acquired bleeding disorders (e.g., directly acting oral anticoagulants (DOACs)) to treat serious bleeding. [45]

Nosebleeds

The use of tranexamic acid, applied directly to the area that is bleeding or taken by mouth, appears useful to treat nose bleeding compared to packing the nose with cotton pledgets alone. [46] [47] [48] It decreases the risk of rebleeding within 10 days. [49]

Cosmetic Uses

Tranexamic acid can be used in skincare products as a cosmetic active to reduce the appearance of inflammation and hyperpigmentation.[ citation needed ] Tranexamic acid is a zwitterion amino acid, and has a low permeability coefficient in the stratum corneum. [50] Tranexamic acid can be combined with penetration enhancers and microneedling to overcome this limitation. [51] Cosmetic uses may also employ lipophilic derivatives of tranexamic acid (ester prodrugs like Cetyl tranexamate mesylate) that are not zwitterionic and thus have improved skin permeability. [52] [53] [54]

Contraindications

Adverse effects

Side effects are rare. [2] Some reported adverse events include seizures, changes in color vision, blood clots, and allergic reactions such as anaphylaxis. [2] Whether the risk of venous thromboembolism (blood clots) is actually increased is a matter of debate. The risk is mentioned in the product literature, [4] and they were reported in post marketing experience. [4] Despite this, and the inhibitory effect of tranexamic acid on blood clot breakdown, large studies of the use of tranexamic acid have not shown an increase in the risk of venous or arterial thrombosis, [55] [56] even in people who had previously experienced thrombosis under other circumstances. [56]

Special populations

Society and culture

Tranexamic acid was first synthesized in 1962 by Japanese researchers Shosuke and Utako Okamoto. [12] It is on the World Health Organization's List of Essential Medicines. [13]

Brand names

Tranexamic acid is marketed in the US and Australia in tablet form as Lysteda [4] and in Australia, Sweden [58] and Jordan it is marketed in an IV form and tablet form as Cyklokapron, in the UK and Sweden [58] as Cyclo-F. In the UK it is also marketed as Femstrual, in Asia as Transcam, in Bangladesh as Intrax & Tracid, in India as Pause, in Pakistan as Transamin, in Indonesia as Kalnex, in South America as Espercil, in Japan as Nicolda, in France, Poland, Belgium and Romania as Exacyl and in Egypt as Kapron. In the Philippines, its capsule form is marketed as Hemostan and in Israel as Hexakapron.[ citation needed ]

The US Food and Drug Administration (FDA) approved tranexamic acid oral tablets (brand name Lysteda) for treatment of heavy menstrual bleeding in November 2009. [4] [59] [60]

In March 2011, the status of tranexamic acid for the treatment of heavy menstrual bleeding was changed in the UK, from POM (Prescription only Medicines) to P (Pharmacy Medicines) [61] and became available over the counter in UK pharmacies under the brand names of Cyklo-F and Femstrual. [62]

Research

Tranexamic acid might alleviate neuroinflammation in some experimental settings. [63]

Tranexamic acid can be used in case of postpartum hemorrhage; it can decrease the risk of death due to bleeding by one third according to the WHO. [64]

Tentative evidence supports the use of tranexamic acid in hemoptysis. [65] [66]

In hereditary angioedema [67]

In hereditary hemorrhagic telangiectasia: tranexamic acid has been shown to reduce frequency of epistaxis in patients with severe and frequent nosebleed episodes from hereditary hemorrhagic telangiectasia. [68]

In melasma: tranexamic acid is sometimes used in skin whitening as a topical agent, injected into a lesion, or taken by mouth, both alone and as an adjunct to laser therapy; as of 2017 its safety seemed reasonable but its efficacy for this purpose was uncertain because there had been no large scale randomized controlled studies nor long term follow-up studies. [69] [70] It is allowed as a quasi-drug for skin whitening in Japan. [71]

In hyphema: tranexamic acid has been shown to be effective in reducing risk of secondary hemorrhage outcomes in people with traumatic hyphema. [72]

In liver resection: tranexamic acid did not reduce bleeding or transfusions but did increase complications. [73]

Related Research Articles

<span class="mw-page-title-main">Gout</span> Form of arthritis causing swollen joints

Gout is a form of inflammatory arthritis characterized by recurrent attacks of pain in a red, tender, hot, and swollen joint, caused by the deposition of needle-like crystals of uric acid known as monosodium urate crystals. Pain typically comes on rapidly, reaching maximal intensity in less than 12 hours. The joint at the base of the big toe is affected (Podagra) in about half of cases. It may also result in tophi, kidney stones, or kidney damage.

<span class="mw-page-title-main">Non-Hodgkin lymphoma</span> Type of cancer of lymph nodes

Non-Hodgkin lymphoma (NHL), also known as non-Hodgkin's lymphoma, is a group of blood cancers that includes all types of lymphomas except Hodgkin lymphomas. Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tiredness. Other symptoms may include bone pain, chest pain, or itchiness. Some forms are slow-growing while others are fast-growing. Unlike Hodgkin lymphoma, which spreads contiguously, NHL is largely a systemic illness.

<span class="mw-page-title-main">Iron deficiency</span> State in which a body lacks enough iron to supply its needs

Iron deficiency, or sideropenia, is the state in which a body lacks enough iron to supply its needs. Iron is present in all cells in the human body and has several vital functions, such as carrying oxygen to the tissues from the lungs as a key component of the hemoglobin protein, acting as a transport medium for electrons within the cells in the form of cytochromes, and facilitating oxygen enzyme reactions in various tissues. Too little iron can interfere with these vital functions and lead to morbidity and death.

<span class="mw-page-title-main">Thalassemia</span> Family of inherited blood disorders

Thalassemias are inherited blood disorders that result in abnormal hemoglobin. Symptoms depend on the type of thalassemia and can vary from none to severe. Often there is mild to severe anemia as thalassemia can affect the production of red blood cells and also affect how long the red blood cells live. Symptoms of anemia include feeling tired and having pale skin. Other symptoms of thalassemia include bone problems, an enlarged spleen, yellowish skin, pulmonary hypertension, and dark urine. Slow growth may occur in children. Symptoms and presentations of thalassemia can change over time. Older terms included Cooley's anemia and Mediterranean anemia for beta-thalassemia. These have been superseded by the terms Transfusion-Dependent Thalassemia (TDT) and non-Transfusion-Dependent Thalassemia (NTDT). Patients with TDT require regular transfusions, typically every two to five weeks. TDTs include Beta-thalassemia major, nondeletional HbH disease, survived Hb Bart's disease, and severe HbE/beta-thalassemia.

<span class="mw-page-title-main">Dysmenorrhea</span> Pain during and sometimes before menstruation

Dysmenorrhea, also known as period pain, painful periods or menstrual cramps, is pain during menstruation. Its usual onset occurs around the time that menstruation begins. Symptoms typically last less than three days. The pain is usually in the pelvis or lower abdomen. Other symptoms may include back pain, diarrhea or nausea.

<span class="mw-page-title-main">Upper gastrointestinal bleeding</span> Bleeding of the esophagus, stomach, or upper intestine

Upper gastrointestinal bleeding (UGIB) is gastrointestinal bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. Blood may be observed in vomit or in altered form as black stool. Depending on the amount of the blood loss, symptoms may include shock.

<span class="mw-page-title-main">Nosebleed</span> Bleeding from the nose

A nosebleed, also known as epistaxis, is an instance of bleeding from the nose. Blood can flow down into the stomach, and cause nausea and vomiting. In more severe cases, blood may come out of both nostrils. Rarely, bleeding may be so significant that low blood pressure occurs. Blood may also be forced to flow up and through the nasolacrimal duct and out of the eye, producing bloody tears.

Heavy menstrual bleeding (HMB), previously known as menorrhagia or hematomunia, is a menstrual period with excessively heavy flow. It is a type of abnormal uterine bleeding (AUB).

<span class="mw-page-title-main">Glanzmann's thrombasthenia</span> Medical condition

Glanzmann's thrombasthenia is an abnormality of the platelets. It is an extremely rare coagulopathy, in which the platelets contain defective or low levels of glycoprotein IIb/IIIa (GpIIb/IIIa), which is a receptor for fibrinogen. As a result, no fibrinogen bridging of platelets to other platelets can occur, and the bleeding time is significantly prolonged.

<span class="mw-page-title-main">Gastrointestinal bleeding</span> Bleeding in the gastrointestinal tract

Gastrointestinal bleeding, also called gastrointestinal hemorrhage (GIB), is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool. Small amounts of bleeding over a long time may cause iron-deficiency anemia resulting in feeling tired or heart-related chest pain. Other symptoms may include abdominal pain, shortness of breath, pale skin, or passing out. Sometimes in those with small amounts of bleeding no symptoms may be present.

<span class="mw-page-title-main">Mefenamic acid</span> Chemical compound

Mefenamic acid is a member of the anthranilic acid derivatives class of nonsteroidal anti-inflammatory drugs (NSAIDs), and is used to treat mild to moderate pain.

<span class="mw-page-title-main">Coagulopathy</span> Condition involving impaired blood clotting ability

Coagulopathy is a condition in which the blood's ability to coagulate is impaired. This condition can cause a tendency toward prolonged or excessive bleeding, which may occur spontaneously or following an injury or medical and dental procedures.

<span class="mw-page-title-main">Fresh frozen plasma</span> Liquid portion of whole blood

Fresh frozen plasma (FFP) is a blood product made from the liquid portion of whole blood. It is used to treat conditions in which there are low blood clotting factors or low levels of other blood proteins. It may also be used as the replacement fluid in plasma exchange. Using ABO compatible plasma, while not required, may be recommended. Use as a volume expander is not recommended. It is administered by slow injection into a vein.

<span class="mw-page-title-main">Aminocaproic acid</span> Chemical compound

Aminocaproic acid is a derivative and analogue of the amino acid lysine, which makes it an effective inhibitor for enzymes that bind that particular residue. Such enzymes include proteolytic enzymes like plasmin, the enzyme responsible for fibrinolysis. For this reason it is effective in treatment of certain bleeding disorders, and it is sold under the brand name Amicar. Aminocaproic acid is also an intermediate in the polymerization of Nylon-6, where it is formed by ring-opening hydrolysis of caprolactam. The crystal structure determination showed that the 6-aminohexanoic acid is present as a salt, at least in the solid state.

<span class="mw-page-title-main">Hyphema</span> Hemorrhage in the front chamber of the eye

Hyphema is the medical condition of bleeding in the anterior chamber of the eye between the iris and the cornea. People usually first notice a loss or decrease in vision. The eye may also appear to have a reddish tinge, or it may appear as a small pool of blood at the bottom of the iris in the cornea. A traumatic hyphema is caused by a blow to the eye. A hyphema can also occur spontaneously.

<span class="mw-page-title-main">Platelet transfusion</span> Treatment for bleeding irregularities

Platelet transfusion, also known as platelet concentrate, is used to prevent or treat bleeding in people with either a low platelet count or poor platelet function. Often this occurs in people receiving cancer chemotherapy. Preventive transfusion is often done in those with platelet levels of less than 10 x 109/L. In those who are bleeding transfusion is usually carried out at less than 50 x 109/L. Blood group matching (ABO, RhD) is typically recommended before platelets are given. Unmatched platelets, however, are often used due to the unavailability of matched platelets. They are given by injection into a vein.

<span class="mw-page-title-main">Postpartum bleeding</span> Loss of blood following childbirth

Postpartum bleeding or postpartum hemorrhage (PPH) is often defined as the loss of more than 500 ml or 1,000 ml of blood following childbirth. Some have added the requirement that there also be signs or symptoms of low blood volume for the condition to exist. Signs and symptoms may initially include: an increased heart rate, feeling faint upon standing, and an increased breathing rate. As more blood is lost, the patient may feel cold, blood pressure may drop, and they may become restless or unconscious. In severe cases circulatory collapse, disseminated intravascular coagulation and death can occur. The condition can occur up to twelve weeks following delivery in the secondary form. The most common cause is poor contraction of the uterus following childbirth. Not all of the placenta being delivered, a tear of the uterus, or poor blood clotting are other possible causes. It occurs more commonly in those who already have a low amount of red blood, are Asian, have a larger fetus or more than one fetus, are obese or are older than 40 years of age. It also occurs more commonly following caesarean sections, those in whom medications are used to start labor, those requiring the use of a vacuum or forceps, and those who have an episiotomy.

<span class="mw-page-title-main">Patient blood management</span> Set of medical practices

Patient Blood Management (PBM) is a set of medical practices designed to optimise the care of patients who might need a blood transfusion. Patient blood management programs use an organized framework to improve blood health, thus increasing patient safety and quality of life, reducing costs, and improving clinical outcomes. Some strategies to accomplish this include ensuring that anemia is treated prior to a surgical operation, using surgical techniques that limit blood loss, and returning blood lost during surgery to the patient via intraoperative blood salvage.

The fibrinolysis system is responsible for removing blood clots. Hyperfibrinolysis describes a situation with markedly enhanced fibrinolytic activity, resulting in increased, sometimes catastrophic bleeding. Hyperfibrinolysis can be caused by acquired or congenital reasons. Among the congenital conditions for hyperfibrinolysis, deficiency of alpha-2-antiplasmin or plasminogen activator inhibitor type 1 (PAI-1) are very rare. The affected individuals show a hemophilia-like bleeding phenotype. Acquired hyperfibrinolysis is found in liver disease, in patients with severe trauma, during major surgical procedures, and other conditions. A special situation with temporarily enhanced fibrinolysis is thrombolytic therapy with drugs which activate plasminogen, e.g. for use in acute ischemic events or in patients with stroke. In patients with severe trauma, hyperfibrinolysis is associated with poor outcome. Moreover, hyperfibrinolysis may be associated with blood brain barrier impairment, a plasmin-dependent effect due to an increased generation of bradykinin.

Haleema Shakur-Still is a professor of Global Health Clinical Trials and the co-director of London School of Hygiene & Tropical Medicine's Clinical Trials Unit.

References

  1. ↑ "Prescription medicines: registration of new generic medicines and biosimilar medicines, 2017". Therapeutic Goods Administration (TGA). 21 June 2022. Archived from the original on 6 July 2023. Retrieved 30 March 2024.
  2. 1 2 3 4 5 6 7 "Cyklokapron Tablets - Summary of Product Characteristics (SPC) - (eMC)". emc. September 2016. Archived from the original on 20 December 2016. Retrieved 14 December 2016.
  3. ↑ "Evana Heavy Period Relief Summary of Product Characteristics (SmPC)". (emc). 24 April 2024. Retrieved 14 May 2024.
  4. 1 2 3 4 5 6 7 8 9 10 "Lysteda- tranexamic acid tablet". DailyMed. 2 December 2021. Archived from the original on 29 March 2021. Retrieved 14 May 2024.
  5. ↑ 会議事録 [Minutes of the meeting]. 薬事・食品衛生審議会一般用医薬品部会 (in Japanese). 22 March 2007. Archived from the original on 7 September 2022. Retrieved 7 September 2022.
  6. 1 2 3 4 British national formulary: BNF 69 (69 ed.). British Medical Association. 2015. p. 170. ISBN   978-0-85711-156-2.
  7. 1 2 Shakur H, Roberts I, Fawole B, Chaudhri R, El-Sheikh M, Akintan A, et al. (WOMAN Trial Collaborators) (2017). "Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial". Lancet. 389 (10084): 2105–2116. doi:10.1016/S0140-6736(17)30638-4. PMC   5446563 . PMID   28456509.
  8. ↑ Law RH, Wu G, Leung EW, Hidaka K, Quek AJ, Caradoc-Davies TT, et al. (2017). "X-ray crystal structure of plasmin with tranexamic acid-derived active site inhibitors". Blood Advances. 1 (12): 766–771. doi:10.1182/bloodadvances.2016004150. PMC   5728053 . PMID   29296720.
  9. ↑ Wu G, Mazzitelli BA, Quek AJ, Veldman MJ, Conroy PJ, Caradoc-Davies TT, et al. (2019). "Tranexamic acid is an active site inhibitor of urokinase plasminogen activator". Blood Advances. 3 (5): 729–733. doi:10.1182/bloodadvances.2018025429. PMC   6418500 . PMID   30814058.
  10. ↑ "Tranexamic acid Use During Pregnancy". Drugs.com. Archived from the original on 21 December 2016. Retrieved 14 December 2016.
  11. ↑ "Tranexamic Acid Injection - FDA prescribing information, side effects and uses". Drugs.com. Archived from the original on 21 December 2016. Retrieved 14 December 2016.
  12. 1 2 Watts G (2016). "Utako Okamoto". Lancet. 387 (10035): 2286. doi: 10.1016/S0140-6736(16)30697-3 . PMID   27308678.
  13. 1 2 World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl: 10665/371090 . WHO/MHP/HPS/EML/2023.02.
  14. ↑ Hamilton R (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 415. ISBN   978-1-284-05756-0.
  15. ↑ Binz S, McCollester J, Thomas S, Miller J, Pohlman T, Waxman D, et al. (2015). "CRASH-2 Study of Tranexamic Acid to Treat Bleeding in Trauma Patients: A Controversy Fueled by Science and Social Media". Journal of Blood Transfusion. 2015: 874920. doi: 10.1155/2015/874920 . PMC   4576020 . PMID   26448897.
  16. ↑ Melvin JS, Stryker LS, Sierra RJ (2015). "Tranexamic Acid in Hip and Knee Arthroplasty". The Journal of the American Academy of Orthopaedic Surgeons. 23 (12): 732–40. doi:10.5435/JAAOS-D-14-00223. PMID   26493971. S2CID   41823501.
  17. 1 2 Tengborn L, Blombäck M, Berntorp E (2015). "Tranexamic acid--an old drug still going strong and making a revival". Thrombosis Research. 135 (2): 231–42. doi:10.1016/j.thromres.2014.11.012. PMID   25559460.
  18. ↑ Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, et al. (March 2013). "The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients". Health Technology Assessment. 17 (10): 1–79. doi:10.3310/hta17100. PMC   4780956 . PMID   23477634.
  19. ↑ Ker K, Roberts I, Shakur H, Coats TJ (May 2015). "Antifibrinolytic drugs for acute traumatic injury". The Cochrane Database of Systematic Reviews. 2015 (5): CD004896. doi:10.1002/14651858.CD004896.pub4. PMC   10589907 . PMID   25956410.
  20. ↑ Cherkas D (November 2011). "Traumatic hemorrhagic shock: advances in fluid management". Emergency Medicine Practice. 13 (11): 1–19, quiz 19–20. PMID   22164397. Archived from the original on 18 January 2012.
  21. ↑ "Drug will save lives of accident victims, says study". BBC News Online. 2010. Archived from the original on 24 June 2010. Retrieved 3 June 2016.
  22. ↑ Napolitano LM, Cohen MJ, Cotton BA, Schreiber MA, Moore EE (June 2013). "Tranexamic acid in trauma: how should we use it?". The Journal of Trauma and Acute Care Surgery. 74 (6): 1575–1586. doi:10.1097/TA.0b013e318292cc54. PMID   23694890. S2CID   9569603.
  23. ↑ "Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial". Lancet. 394 (10210): 1713–1723. November 2019. doi:10.1016/S0140-6736(19)32233-0. PMC   6853170 . PMID   31623894.
  24. ↑ Lukes AS, Moore KA, Muse KN, Gersten JK, Hecht BR, Edlund M, et al. (2010). "Tranexamic acid treatment for heavy menstrual bleeding: a randomized controlled trial". Obstetrics and Gynecology. 116 (4): 865–75. doi:10.1097/AOG.0b013e3181f20177. PMID   20859150. S2CID   6977827.
  25. ↑ Naoulou B, Tsai MC (2012). "Efficacy of tranexamic acid in the treatment of idiopathic and non-functional heavy menstrual bleeding: a systematic review". Acta Obstetricia et Gynecologica Scandinavica. 91 (5): 529–37. doi: 10.1111/j.1600-0412.2012.01361.x . PMID   22229782. S2CID   8862324.
  26. ↑ Kai J, Dutton B, Vinogradova Y, Hilken N, Gupta J, Daniels J (October 2023). "Rates of medical or surgical treatment for women with heavy menstrual bleeding: the ECLIPSE trial 10-year observational follow-up study". Health Technology Assessment. 27 (17): 1–50. doi:10.3310/JHSW0174. PMC   10641716 . PMID   37924269.
  27. ↑ "The coil and medicines are both effective long-term treatments for heavy periods". NIHR Evidence. 8 March 2024. doi:10.3310/nihrevidence_62335. Archived from the original on 18 March 2024. Retrieved 12 April 2024.
  28. ↑ "Postpartum Haemorrhage, Prevention and Management (Green-top Guideline No. 52)". Royal College of Obstetricians & Gynaecologists-US. Archived from the original on 19 January 2019. Retrieved 16 January 2018.
  29. 1 2 Henry DA, Carless PA, Moxey AJ, O'Connell D, Stokes BJ, Fergusson DA, et al. (The Cochrane Collaboration) (2011). Henry DA (ed.). "Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion". The Cochrane Database of Systematic Reviews. 2011 (3). John Wiley & Sons, Ltd: CD001886. doi:10.1002/14651858.cd001886.pub4. PMC   4234031 . PMID   21412876.
  30. ↑ Ker K, Edwards P, Perel P, Shakur H, Roberts I (2012). "Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis". BMJ. 344: e3054. doi:10.1136/bmj.e3054. PMC   3356857 . PMID   22611164.
  31. ↑ Ker K, Prieto-Merino D, Roberts I (2013). "Systematic review, meta-analysis and meta-regression of the effect of tranexamic acid on surgical blood loss" (PDF). The British Journal of Surgery. 100 (10): 1271–9. doi:10.1002/bjs.9193. PMID   23839785. S2CID   25033742. Archived (PDF) from the original on 8 August 2019. Retrieved 8 August 2019.
  32. ↑ RCPCH. "Evidence Statement Major trauma and the use of tranexamic acid in children Nov 2012" (PDF). Retrieved 17 December 2012.[ permanent dead link ]
  33. ↑ Sethna NF, Zurakowski D, Brustowicz RM, Bacsik J, Sullivan LJ, Shapiro F (2005). "Tranexamic acid reduces intraoperative blood loss in pediatric patients undergoing scoliosis surgery". Anesthesiology. 102 (4): 727–32. doi: 10.1097/00000542-200504000-00006 . PMID   15791100. S2CID   790638.
  34. ↑ Pernik MN, Dosselman LJ, Aoun SG, Walker AD, Hall K, Peinado Reyes V, et al. (2020). "The effectiveness of tranexamic acid on operative and perioperative blood loss in long-segment spinal fusions: a consecutive series of 119 primary procedures". Journal of Neurosurgery. Spine. 32 (5): 768–774. doi: 10.3171/2019.11.SPINE191174 . PMID   31978874.
  35. ↑ "Cyklokapron (tranexamic acid) Product Information" (PDF). Archived from the original (PDF) on 29 February 2016. Retrieved 3 November 2015.
  36. ↑ Forbes CD, Barr RD, Reid G, Thomson C, Prentice CR, McNicol GP, et al. (1972). "Tranexamic acid in control of haemorrhage after dental extraction in haemophilia and Christmas disease". British Medical Journal. 2 (5809): 311–3. doi:10.1136/bmj.2.5809.311. PMC   1788188 . PMID   4553818.
  37. ↑ van Galen KP, Engelen ET, Mauser-Bunschoten EP, van Es RJ, Schutgens RE (2019). "Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions". The Cochrane Database of Systematic Reviews. 2019 (4): CD011385. doi:10.1002/14651858.CD011385.pub3. PMC   6474399 . PMID   31002742.
  38. ↑ Chen Z. "牙膏可添加氨甲环酸" [Tranexamic acid is allowed in toothpastes]. People's Daily Online, Health Section (in Chinese). Archived from the original on 7 September 2022. Retrieved 7 September 2022.
  39. ↑ "LC Paper No. CB(3) 61/07-08 Proposed resolution under the Pharmacy and Poisons Ordinance" (PDF). Hong Kong LegCo. 7 November 2007. Archived (PDF) from the original on 7 September 2022. Retrieved 7 September 2022.
  40. ↑ "牙膏含"氨甲环酸"是处方药？看看牙膏里的秘密" [TXA in toothpaste a prescription drug? Secrets of toothpastes]. news.sina.com.cn. 中国新闻周刊 [China News Weekly]. 31 October 2018. Archived from the original on 7 September 2022. Retrieved 7 September 2022.
  41. ↑ "How to Choose Toothpaste". ion Corporation. Archived from the original on 7 September 2022. Retrieved 7 September 2022. if toothpaste has a label of "quasi drug", this indicates that the product contains active ingredients [...] Tranexamic acid
  42. ↑ "Unauthorized". Health Canada. Government of Canada. 4 October 2019. Archived from the original on 5 December 2019. Retrieved 30 July 2020.
  43. 1 2 Estcourt LJ, Desborough M, Brunskill SJ, Doree C, Hopewell S, Murphy MF, et al. (2016). "Antifibrinolytics (lysine analogues) for the prevention of bleeding in people with haematological disorders". The Cochrane Database of Systematic Reviews. 2016 (3): CD009733. doi:10.1002/14651858.CD009733.pub3. PMC   4838155 . PMID   26978005.
  44. ↑ "Tranexamic acid". Clinical Transfusion. International Society of Blood Transfusion (ISBT). Archived from the original on 17 January 2018. Retrieved 16 January 2018.
  45. ↑ Siegal DM, Garcia DA, Crowther MA (2014). "How I treat target-specific oral anticoagulant-associated bleeding". Blood. 123 (8): 1152–8. doi: 10.1182/blood-2013-09-529784 . PMID   24385535.
  46. ↑ Ker K, Beecher D, Roberts I (2013). Ker K (ed.). "Topical application of tranexamic acid for the reduction of bleeding" (PDF). The Cochrane Database of Systematic Reviews (7): CD010562. doi:10.1002/14651858.CD010562.pub2. PMID   23881695. Archived (PDF) from the original on 27 April 2019. Retrieved 30 November 2019.
  47. ↑ Logan JK, Pantle H (2016). "Role of topical tranexamic acid in the management of idiopathic anterior epistaxis in adult patients in the emergency department". American Journal of Health-System Pharmacy. 73 (21): 1755–1759. doi: 10.2146/ajhp150829 . PMID   27769971.
  48. ↑ Williams A, Biffen A, Pilkington N, Arrick L, Williams RJ, Smith ME, et al. (2017). "Haematological factors in the management of adult epistaxis: systematic review". The Journal of Laryngology and Otology. 131 (12): 1093–1107. doi:10.1017/S0022215117002067. PMID   29280698. S2CID   45310419.
  49. ↑ Gottlieb M, Koyfman A, Long B (2019). "Tranexamic Acid for the Treatment of Epistaxis". Academic Emergency Medicine. 26 (11): 1292–1293. doi: 10.1111/acem.13760 . PMID   30933392.
  50. ↑ Hatanaka T, Kamon T, Uozumi C, Morigaki S, Aiba T, Katayama K, et al. (July 1996). "Influence of pH on skin permeation of amino acids". The Journal of Pharmacy and Pharmacology. 48 (7): 675–9. doi:10.1111/j.2042-7158.1996.tb03949.x. PMID   8866327.
  51. ↑ Ziaeifar E, Ziaeifar F, Mozafarpoor S, Goodarzi A (November 2021). "Applications of microneedling for various dermatologic indications with a special focus on pigmentary disorders: A comprehensive review study". Dermatologic Therapy. 34 (6): e15159. doi: 10.1111/dth.15159 . PMID   34657363.
  52. ↑ Vávrová K, Hrabálek A, Dolezal P, Holas T, Klimentová J (May 2005). "Biodegradable derivatives of tranexamic acid as transdermal permeation enhancers". Journal of Controlled Release. 104 (1): 41–49. doi:10.1016/j.jconrel.2005.01.002. PMID   15866333.
  53. ↑ Bundgaard H (January 1989). "The double prodrug concept and its applications". Advanced Drug Delivery Reviews. 3 (1): 39–65. doi:10.1016/0169-409x(89)90004-5.
  54. ↑ Zhang Q, Grice JE, Wang G, Roberts MS (March 2009). "Cutaneous metabolism in transdermal drug delivery". Current Drug Metabolism. 10 (3): 227–35. doi:10.2174/138920009787846350. PMID   19442085.
  55. ↑ Chornenki NL, Um KJ, Mendoza PA, Samienezhad A, Swarup V, Chai-Adisaksopha C, et al. (2019). "Risk of venous and arterial thrombosis in non-surgical patients receiving systemic tranexamic acid: A systematic review and meta-analysis". Thrombosis Research. 179: 81–86. doi:10.1016/j.thromres.2019.05.003. PMID   31100632. S2CID   157066652.
  56. 1 2 Taeuber I, Weibel S, Herrmann E, Neef V, Schlesinger T, Kranke P, et al. (April 2021). "Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality: A Systematic Review, Meta-analysis, and Meta-regression". JAMA Surgery. 156 (6): e210884. doi:10.1001/jamasurg.2021.0884. PMC   8047805 . PMID   33851983.
  57. ↑ "Tranexamic Acid use while Breastfeeding". www.drugs.com. 2014. Archived from the original on 18 September 2016. Retrieved 27 May 2016.
  58. 1 2 "Substans - Tranexamsyra". FASS. FASS.se. Archived from the original on 19 April 2021. Retrieved 19 April 2021.
  59. ↑ "Drug Approval Package: Lysteda (tranexamic acid) NDA #022430". U.S. Food and Drug Administration (FDA). 6 May 2010. Archived from the original on 16 April 2024. Retrieved 14 May 2024.
  60. ↑ "Xanodyne Announces FDA Approval of Lysteda (Tranexamic Acid) for Treatment of Women with Heavy Menstrual Bleeding". Drugs.com (Press release). Archived from the original on 31 July 2022. Retrieved 11 December 2020.
  61. ↑ Chapman C (27 January 2011). "Tranexamic Acid to be available OtC". Community pharmacy news, analysis and CPD. Archived from the original on 9 October 2011.
  62. ↑ Chapman C (10 February 2011). "In defence of multiple pharmacies". Community pharmacy news, analysis and CPD. Archived from the original on 28 March 2012.
  63. ↑ Atsev S, Tomov N (2020). "Using antifibrinolytics to tackle neuroinflammation". Neural Regeneration Research. 15 (12): 2203–2206. doi: 10.4103/1673-5374.284979 . PMC   7749481 . PMID   32594031.
  64. ↑ "WHO | WHO updates recommendation on intravenous tranexamic acid for the treatment of postpartum haemorrhage". Archived from the original on 9 July 2021. Retrieved 23 August 2020.
  65. ↑ Moen CA, Burrell A, Dunning J (2013). "Does tranexamic acid stop haemoptysis?". Interactive Cardiovascular and Thoracic Surgery. 17 (6): 991–4. doi:10.1093/icvts/ivt383. PMC   3829500 . PMID   23966576.
  66. ↑ Prutsky G, Domecq JP, Salazar CA, Accinelli R (2016). "Antifibrinolytic therapy to reduce haemoptysis from any cause". The Cochrane Database of Systematic Reviews. 2016 (11): CD008711. doi:10.1002/14651858.CD008711.pub3. PMC   6464927 . PMID   27806184. Archived from the original on 5 July 2018. Retrieved 5 July 2018.
  67. ↑ Flower R, Rang HP, Dale MM, Ritter JM (2007). Rang & Dale's pharmacology . Edinburgh: Churchill Livingstone. ISBN   978-0-443-06911-6.[ page needed ]
  68. ↑ Klepfish A, Berrebi A, Schattner A (2001). "Intranasal tranexamic acid treatment for severe epistaxis in hereditary hemorrhagic telangiectasia". Archives of Internal Medicine. 161 (5): 767. doi:10.1001/archinte.161.5.767. PMID   11231712.
  69. ↑ Zhou LL, Baibergenova A (2017). "Melasma: systematic review of the systemic treatments". International Journal of Dermatology. 56 (9): 902–908. doi:10.1111/ijd.13578. PMID   28239840. S2CID   21683251.
  70. ↑ Taraz M, Niknam S, Ehsani AH (May 2017). "Tranexamic acid in treatment of melasma: A comprehensive review of clinical studies". Dermatologic Therapy. 30 (3): e12465. doi: 10.1111/dth.12465 . PMID   28133910. S2CID   3910189.
  71. ↑ Ando H, Matsui MS, Ichihashi M (June 2010). "Quasi-drugs developed in Japan for the prevention or treatment of hyperpigmentary disorders". International Journal of Molecular Sciences. 11 (6): 2566–2575. doi: 10.3390/ijms11062566 . PMC   2904932 . PMID   20640168.
  72. ↑ Woreta FA, Lindsley KB, Gharaibeh A, Ng SM, Scherer RW, Goldberg MF (March 2023). "Medical interventions for traumatic hyphema". The Cochrane Database of Systematic Reviews. 2023 (3): CD005431. doi:10.1002/14651858.CD005431.pub5. PMC   10010597 . PMID   36912744.
  73. ↑ Karanicolas PJ, Lin Y, McCluskey SA, Tarshis J, Thorpe KE, Wei A, et al. (August 2024). "Tranexamic Acid in Patients Undergoing Liver Resection: The HeLiX Randomized Clinical Trial". JAMA. doi:10.1001/jama.2024.11783. PMID   39158894.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.