The Medical Letter on Drugs and Therapeutics
Tranexamic Acid (Lysteda) for Treatment of Menorrhagia
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The FDA has approved the use of tranexamic acid (Lysteda – Ferring), an oral antifibrinolytic, for treatment of menorrhagia. Tranexamic acid has been used for this purpose in Europe for decades, and is available without a prescription in some countries. It has been available in the US since 1987 for use with coagulation factors in patients with hemophilia undergoing dental extractions.

MECHANISM OF ACTION — Women with menorrhagia have elevated levels of tissue plasminogen activator (tPA). Tranexamic acid is thought to lower endometrial tPA activity, resulting in decreased blood loss. It blocks lysine binding sites on plasminogen molecules, preventing plasmin formation and menstrual fluid fibrinolysis.

ALTERNATIVES — Other medications used to treat menorrhagia have included oral contraceptives1 and a levonorgestrel-releasing intrauterine device ... more      

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