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Tranexamic Acid is an antifibrinolytic (a synthetic derivative of the amino acid lysine) that Bayview compounds to a prescriber's order.
Tranexamic acid is a synthetic analog of the amino acid lysine with antifibrinolytic properties. It competitively inhibits the activation of plasminogen, which prevents plasmin from breaking down fibrin and stabilizes fibrin clots, reducing bleeding.[1]
In dermatology, tranexamic acid has been studied for melasma. Oral tranexamic acid has a substantial evidence base as an adjunctive, off-label therapy for melasma, and topical and intradermal use is increasingly being investigated.[2]
The FDA-approved indications for tranexamic acid are heavy menstrual bleeding and short-term use in patients with hemophilia, such as around tooth extraction. Intravenous tranexamic acid is also used off-label in trauma patients with severe bleeding and during surgery to reduce blood loss.[1] Reported adverse effects include headache, backache, abdominal pain, nausea, vomiting, diarrhea, fatigue, visual disturbances, seizures, anaphylaxis, and thromboembolic events such as deep vein thrombosis and pulmonary embolism.[1]
After oral administration, peak plasma concentration is reached at about 3 hours. About 95% of a dose is excreted unchanged in the urine, so renal dose adjustment is recommended in patients with renal impairment.[1]
Compounded at Bayview
Patient guides for the preparations we make most often. Each one is compounded to order and requires a prescription.
For prescribers
Every preparation in our formulary that contains this ingredient. Strength, base and dose form are set by the prescription.
It is an antifibrinolytic. It slows the breakdown of blood clots, which reduces bleeding. Oral tablets are FDA-approved for cyclic heavy menstrual bleeding, and the injection is approved as well.
In the skin the reasoning is different and has nothing to do with clotting: by reducing plasmin activity in skin cells, tranexamic acid is thought to lower the signals that prompt pigment production. That mechanism is plausible but not settled.
Anyone with active clotting or thromboembolic disease, a history of or intrinsic risk of thrombosis including retinal vein or artery occlusion, a past subarachnoid hemorrhage, or an allergy to it.
Combination hormonal contraception, the pill, patch, or ring, is a contraindication in the FDA label, because the combination further raises clot risk. Many people treated for melasma or heavy periods are on it, so tell your prescriber. Kidney disease requires a lower dose.
Other salt forms of this molecule, and ingredients commonly compounded alongside it.
This page describes an active pharmaceutical ingredient, not a finished drug product. Bayview Pharmacy compounds preparations containing it only on a prescriber's order for an individual patient.
Compounded preparations are not FDA-approved, and the FDA has not evaluated them for safety, effectiveness, or manufacturing quality. Nothing on this page is a claim that any preparation is effective for any condition.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice — discuss your situation with a licensed healthcare provider.
Our pharmacists work with prescribers to build preparations around a patient's dose, form and tolerances. Ask us what is possible with this ingredient.
