Tranexamic Acid — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Tranexamic Acid?
Tranexamic acid is an antifibrinolytic medicine that reduces bleeding by preventing the breakdown of blood clots. This medication is funded by Pharmac for menorrhagia and bleeding conditions.
What is Tranexamic Acid Used For?
Tranexamic acid is used to reduce bleeding in heavy menstrual bleeding (menorrhagia), dental and surgical procedures (particularly in patients on anticoagulants), trauma-associated haemorrhage, postpartum haemorrhage, and hereditary haemophilia.
How Does Tranexamic Acid Work?
Tranexamic acid competitively inhibits the binding of plasminogen and plasmin to fibrin, blocking the activation of plasminogen to plasmin. This prevents clot dissolution (fibrinolysis) — stabilising existing clots and reducing ongoing blood loss without directly causing new clot formation.
How to Take Tranexamic Acid
For heavy menstrual bleeding: 1 g (two 500 mg tablets) three to four times daily during menstruation for a maximum of 4 days per cycle. For dental procedures: 1 g three times daily starting morning of procedure. For trauma/postpartum haemorrhage: IV infusion (loading dose 1 g over 10 minutes, then 1 g over 8 hours — given as soon as possible after bleeding onset).
Common Side Effects of Tranexamic Acid
- Nausea and vomiting
- Diarrhoea
- Abdominal pain
- Headache
- Dizziness
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Thromboembolism (theoretical risk — particularly in patients with pre-existing thrombotic risk factors)
- Seizures (at very high doses — particularly with IV use)
- Visual disturbances or colour vision changes (with prolonged high-dose use — rare)
Drug Interactions
Tranexamic Acid may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- Combined oral contraceptive pill (possible increased thrombotic risk — use with caution)
- Other procoagulants (additive thrombotic risk)
New Zealand Prescribing Information
Tranexamic acid (500 mg tablets — Cyklokapron® and generics; 100 mg/mL injection) is funded by Pharmac. It is the most evidence-based first-line pharmacological treatment for heavy menstrual bleeding in NZ — reducing menstrual blood loss by approximately 40–50% compared to placebo. Its use in trauma haemorrhage is supported by the CRASH-2 trial demonstrating reduced mortality when given early (within 3 hours of injury).
Frequently Asked Questions
Is tranexamic acid a blood clot medicine?
It prevents the breakdown of blood clots that have already formed — it does not cause new blood clots to form. The risk of causing new thromboembolism (DVT or PE) is very low at standard doses for menorrhagia. It is safe to use in most women, including those not on hormonal treatment.
How quickly does tranexamic acid work for heavy periods?
Tranexamic acid typically reduces menstrual blood loss by approximately 40–50% per cycle when taken as directed. It only works during the days it is taken — it does not prevent periods or affect cycle length. Effects can be noticed from the first cycle of use.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: