Tranexamic Acid

• Postpartum haemorrhage (within 3 h)
• Menorrhagia
• Adjunct in elective CS (off-label)

Binds plasminogen → blocks conversion to plasmin → ↓ fibrinolysis → clot stabilisation.

• 1 g IV over 10 min
• Repeat 1 g after 30 min if bleeding continues
• Maximum benefit within 3 h of birth

PPH

1 g IV over 10 min; repeat at 30 min if needed

Menorrhagia

1 g PO TDS for ≤4 days during menses

• AbsoluteActive VTE, history of thromboembolic disease
• AbsoluteSevere renal impairment (dose-adjust)

• Nausea, diarrhoea
• Visual disturbance (rare)
• Theoretical VTE risk (not seen in WOMAN)

• • Used postpartum — safe in lactation (low transfer).

• Combined OCP

  Caution

  Theoretical VTE risk

• 💡 Reduced death from bleeding by 31% if given <3 h (WOMAN trial).
• 💡 No effect if given >3 h — do not delay.