Tranexamic Acid Side Effects and Possible Drug Interactions

Tranexamic acid is used to control heavy menstrual bleeding. It's available as a brand-name drug called Lysteda. You can get it only with a doctor's prescription.

Heavy or prolonged menstrual bleeding is known as menorrhagia. In America, about 1 in every 5 women experience menorrhagia each year.

Tranexamic acid is usually the first line of treatment for heavy periods.

As an antifibrinolytic agent, tranexamic acid works by stopping the breakdown of fibrin, the main protein in blood clots. This controls or prevents excessive bleeding by helping the blood clot.

Tranexamic acid is taken as an oral tablet. It's also available as an injection, but this form is typically used to control severe bleeding due to surgery or trauma.

Oral tranexamic acid may cause side effects like nausea, diarrhea, and stomach issues. In rare cases, it can lead to anaphylaxis or vision problems.

Your doctor will decide if tranexamic acid is right for you.

Common tranexamic acid side effects

Tranexamic acid can cause minor side effects. As your body gets used to the medicine, these side effects might go away.

The more common side effects of tranexamic acid include:

  • nausea
  • diarrhea
  • stomach pain or discomfort
  • vomiting
  • chills
  • fever
  • severe headache (throbbing)
  • back or joint pain
  • muscle pain
  • muscle stiffness
  • difficulty moving
  • runny or stuffy nose

Usually, these minor side effects don't require medical attention.

If you're concerned about these side effects, talk to your doctor. They might be able to explain how to decrease or prevent common side effects.

Call your doctor if you develop side effects that aren't on this list.

Serious tranexamic acid side effects

Call or visit your doctor immediately if you have serious side effects. If your symptoms feel life-threatening, call 911 right away.

Serious side effects are rare, but life-threatening.

Tranexamic acid may cause a severe allergic reaction, including anaphylaxis.

Medical emergency

Anaphylaxis is a medical emergency. Symptoms of anaphylaxis include:

  • difficulty breathing
  • shortness of breath
  • fast heartbeat
  • chest pain or tightness
  • difficulty swallowing
  • flushing in the face
  • swelling of the mouth, eyelids, or face
  • swelling of the arms or legs
  • skin rash or hives
  • itching
  • dizziness
  • fainting

Tranexamic acid may also cause other serious side effects, including:

  • changes in vision
  • coughing
  • confusion
  • anxiety
  • pale skin
  • unusual bleeding
  • unusual bruising
  • unusual exhaustion or weakness
  • numbness in the hands

If you develop eye problems while taking tranexamic acid, you might need to see an eye doctor.

Long-term tranexamic acid side effects

Generally, using tranexamic acid for a long time doesn't cause harmful side effects.

In a 2011 study, 723 women with heavy periods took tranexamic acid for up to 27 menstrual cycles. The medicine was well-tolerated when used properly.

However, more research is needed to establish the optimal duration and dose of tranexamic acid.

Your doctor will explain how long you should take it. This will be different for each person, so always follow your doctor's directions.

Tranexamic acid drug interactions

Tranexamic acid can interact with certain drugs. If you're already taking other medicine, be sure to tell your doctor.

Typically, it's not recommended to take tranexamic acid with the following:

  • Hormonal birth control. This includes the patch, intrauterine device, and vaginal ring, as well as birth control pills. Taking tranexamic acid with combination hormonal contraception may also increase your risk of blood clot, stroke, or heart attack, especially if you smoke.
  • Anti-inhibitor coagulant complex. This drug is also used to reduce and prevent excessive bleeding.
  • Chlorpromazine. Chlorpromazine is an antipsychotic medicine. It's rarely prescribed, so tell a doctor if you're taking this drug.
  • Tretinoin. This medicine is a retinoid that's used to treat acute promyelocytic leukemia, a type of cancer. Using tranexamic acid with tretinoin might cause bleeding issues.

If you're taking hormonal birth control, your doctor may not prescribe tranexamic acid.

In other cases, you might need to take tranexamic acid with one of the other drugs on this list.

If so, your doctor may change your dose or provide special instructions.

Check with your doctor before taking any prescription or nonprescription drugs. This includes over-the-counter medicine like vitamins or herbal supplements.

Alternative medications for heavy periods

Tranexamic acid isn't for everyone. If it stops working or doesn't decrease heavy menstrual bleeding within two cycles, your doctor might suggest other medications for heavy periods.

You can also use these drugs if the side effects are hard to manage. Alternative medications include:

  • NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen sodium (Aleve) are available without a prescription. NSAIDs can decrease menstrual bleeding and painful cramps.
  • Oral contraceptives. If you have irregular or heavy periods, your doctor might recommend oral contraceptives. This medicine also provides birth control.
  • Oral hormone therapy. Hormone therapy includes drugs with progesterone or estrogen. They can decrease heavy period bleeding by improving hormonal imbalance.
  • Hormonal IUD. An intrauterine device (IUD) releases levonorgestrel, a hormone that thins the uterine lining. This reduces excessive bleeding and cramps during menstruation.
  • Desmopressin nasal spray. If you have a bleeding disorder, like mild hemophilia or von Willebrand disease, you may be given desmopressin nasal spray. This prevents bleeding by helping the blood clot.

The best option depends on your overall health, medical history, and age.

The takeaway

Tranexamic acid is the generic form of Lysteda, a brand-name drug for heavy periods. It reduces excessive menstrual bleeding by helping the blood clot.

Common side effects include nausea, diarrhea, and stomach pain. These minor side effects may disappear as your body gets used to the medicine.

In rare cases, tranexamic acid can cause serious side effects like anaphylaxis or eye problems. Get medical help if you have trouble breathing, swelling, or changes in vision. These side effects are life-threatening.

If tranexamic acid doesn't work for you, or if the side effects are bothersome, your doctor may suggest alternative medications for heavy periods. This might include NSAIDs, a hormonal IUD, oral contraceptives, or oral hormonal therapy.

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