Reducing Heavy Menstrual Bleeding: Safety and Efficacy of Tranexamic Acid:

Menorrhagia or Heavy Menstrual Bleeding (HMB) remains a public health challenge among women in the reproductive age group. Anti-fibrinolytics such as tranexamic acid and epsilon aminocaproic acid, play an important role in the medical management of HMB, as HMB is associated with an increase in local fibrinolysis. Lysteda is a novel oral formulation of tranexamic acid which has recently been approved by the US FDA for treatment of HMB. Efficacy of tranexamic acid in the general gynecologic population as well as in women with bleeding disorders is discussed in this review. Safety and adverse effect profile is also addressed for both these populations.

[1]  J. Lavigne,et al.  Pharmacokinetic Studies in Women of 2 Novel Oral Formulations of Tranexamic Acid Therapy for Heavy Menstrual Bleeding , 2012, American journal of therapeutics.

[2]  A. Waldbaum,et al.  Long-Term Evaluation of Safety and Health-Related Quality of Life in Women with Heavy Menstrual Bleeding Treated with Oral Tranexamic Acid , 2011, Women's health.

[3]  E. Freeman,et al.  A dose-response study of a novel, oral tranexamic formulation for heavy menstrual bleeding. , 2011, American journal of obstetrics and gynecology.

[4]  E. Freeman,et al.  Safety of Tranexamic Acid in Women with Heavy Menstrual Bleeding: An Open-Label Extension Study , 2011, Women's health.

[5]  P. Kouides,et al.  Tranexamic Acid: A Novel Oral Formulation for the Treatment of Heavy Menstrual Bleeding , 2011, Women's health.

[6]  H. Richter,et al.  Tranexamic Acid Treatment for Heavy Menstrual Bleeding: A Randomized Controlled Trial , 2010, Obstetrics and gynecology.

[7]  P. Maison-Blanche,et al.  Thorough cardiac QTc interval conductance assessment of a novel oral tranexamic acid treatment for heavy menstrual bleeding , 2010, Expert opinion on pharmacotherapy.

[8]  N. Dowling,et al.  Multisite management study of menorrhagia with abnormal laboratory haemostasis: a prospective crossover study of intranasal desmopressin and oral tranexamic acid , 2009, British journal of haematology.

[9]  Ambarina S. Faiz,et al.  Development of a screening tool for identifying women with menorrhagia for hemostatic evaluation. , 2008, American journal of obstetrics and gynecology.

[10]  J. Goudemand,et al.  Management of excessive menstrual bleeding in women with hemostatic disorders. , 2005, Fertility and sterility.

[11]  Ambarina S. Faiz,et al.  Age and the Prevalence of Bleeding Disorders in Women With Menorrhagia , 2005, Obstetrics and gynecology.

[12]  J. Levy.  Hemostatic agents , 2004, Transfusion.

[13]  A. Douglas,et al.  Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods: a survey with follow-up data. , 2004, American journal of obstetrics and gynecology.

[14]  A. Heintz,et al.  Cost‐effectiveness of transvaginal sonography and saline infused sonography in the evaluation of menorrhagia , 2003, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[15]  M. Blombäck,et al.  Desmopressin in the treatment of menorrhagia in women with no common coagulation factor deficiency but with prolonged bleeding time , 2002, Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.

[16]  Gynecologists.  ACOG committee opinion. Von Willebrand's disease in gynecologic practice. , 2002, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[17]  S. Lethagen,et al.  No Increased Risk of Venous Thrombosis in Women Taking Tranexamic Acid , 2001, Thrombosis and Haemostasis.

[18]  Mannucci,et al.  Optimising local therapy during oral surgery in patients with von Willebrand disease: effective results from a retrospective analysis of 63 cases , 2000, Haemophilia : the official journal of the World Federation of Hemophilia.

[19]  N. Gleeson.  Cyclic changes in endometrial tissue plasminogen activator and plasminogen activator inhibitor type 1 in women with normal menstruation and essential menorrhagia. , 1994, American journal of obstetrics and gynecology.

[20]  J. Bonnar,et al.  The effect of tranexamic acid on measured menstrual loss and endometrial fibrinolytic enzymes in dysfunctional uterine bleeding , 1994, Acta obstetricia et gynecologica Scandinavica.

[21]  S. Lethagen,et al.  Effects of desmopressin acetate (DDAVP) and dextran on hemostatic and thromboprophylactic mechanisms. , 1990, Acta chirurgica Scandinavica.

[22]  J. Bonnar,et al.  The fibrinolytic enzyme system in normal menstruation and excessive uterine bleeding and the effect of tranexamic acid. , 1987, European journal of obstetrics, gynecology, and reproductive biology.

[23]  S. Thorsen.  Differences in the binding to fibrin of native plasminogen and plasminogen modified by proteolytic degradation. Influence of omega-aminocarboxylic acids. , 1975, Biochimica et biophysica acta.

[24]  S. Rainsford,et al.  Tranexamic Acid in the Control of Spontaneous Bleeding in Severe Haemophilia , 1973, Thrombosis and Haemostasis.

[25]  Michael Pugh.  von Willebrand's Disease in Gynecologic and Obstetric Practice , 1972 .

[26]  I. Fraser,et al.  A Benefit-Risk Review of Systemic Haemostatic Agents , 2008, Drug safety.

[27]  I. Fraser,et al.  A Benefit-Risk Review of Systemic Haemostatic Agents , 2008, Drug safety.

[28]  V. Picozzi,et al.  Bleeding disorders in premenopausal women: (another) public health crisis for hematology? , 2006, Hematology. American Society of Hematology. Education Program.

[29]  J. Vessman,et al.  Pharmacokinetics and bioavailability of tranexamic acid , 2004, European Journal of Clinical Pharmacology.

[30]  P. Hedlund,et al.  Special considerations with regard to the dosage of tranexamic acid in patients with chronic renal diseases , 2004, Urological Research.

[31]  ACOG practice bulletin: management of anovulatory bleeding. , 2001, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.