Tranexamic acid is a prescription medicine that reduces bleeding by stopping blood clots from breaking down too early. In South Africa it is most often used for heavy menstrual periods, and in hospitals for bleeding after trauma, surgery, childbirth, nosebleeds and bleeding in the gut. The usual tablet strength is 500 mg.
What is Tranexamic Acid?
Tranexamic acid is an antifibrinolytic. The South African Medicine Price Registry lists it under many names, all Schedule 4 (prescription-only):
| Product | Form | Strength |
|---|---|---|
| Bio Tranexamic 500, Morwak, Fibtin | Tablet | 500 mg |
| Emkapron 500 | Film-coated tablet | 500 mg |
| Cyklo-type injections, Hemopron, Cynex, Haemostop, Tranmenxio | Injection | 500 mg / 5 ml |
| Tranexamic Injection Pharma-Q | Injection | 1,000 mg / 10 ml |
One registry entry (Haemostop) lists the ingredient twice, once with a misspelling. That is a data-entry artefact in the register, not a second ingredient.
The way it works is worth understanding, because it explains both what it does and what it does not do. When you bleed, your body forms a clot — and simultaneously begins dissolving it, a process called fibrinolysis. Tranexamic acid blocks that dissolving step. The clot that forms is allowed to hold.
The practical consequence is that it reduces bleeding that is already happening. It is not a treatment for the cause of the bleeding, and it does not make blood clot faster in the first place.
What is Tranexamic Acid commonly used for?
- Heavy menstrual bleeding (menorrhagia). This is the most common outpatient use in South Africa. Taken only during the days of heaviest flow, it typically reduces blood loss substantially. It is non-hormonal, which makes it an option for women who cannot or prefer not to use hormonal treatment.
- Bleeding in the digestive tract, including some cases of upper gastrointestinal bleeding, under medical supervision.
- Bleeding after surgery, particularly dental extractions, and in orthopaedic, cardiac and gynaecological procedures.
- Major trauma. Given early after serious injury, it reduces deaths from bleeding — one of the better-established emergency treatments in modern medicine.
- Postpartum haemorrhage — heavy bleeding after childbirth.
- Recurrent nosebleeds that are difficult to control.
- Bleeding disorders such as haemophilia and von Willebrand disease, often around dental or surgical procedures.
- Blood in the urine from certain causes, under specialist direction.
Searches for “tranexamic acid 500 mg used for” are usually about the tablet, and the answer is almost always heavy periods. Note that it is taken during the bleeding, not continuously through the month.
You may also see tranexamic acid in skin-lightening creams for melasma. That is an entirely separate, topical use and has nothing to do with the tablets discussed here.
How Tranexamic Acid fits into this medicine category
| Group | Examples | What it does |
|---|---|---|
| Antifibrinolytics | Tranexamic acid | Prevents clots breaking down; reduces active bleeding |
| Acid suppressants | Omeprazole, cimetidine | Reduce stomach acid, allowing ulcers to heal |
| Antispasmodics | Hyoscine (Hyospasmol) | Relieve gut cramping |
| Anti-nausea | Metoclopramide (Adco-Contromet) | Nausea and vomiting, gut motility |
| Anticoagulants | Warfarin, rivaroxaban | The opposite effect — they prevent clots forming |
That last row is the key contrast. Anticoagulants thin the blood; tranexamic acid protects clots that have already formed. They pull in opposite directions, which is why anyone on a blood thinner must tell their doctor before taking it. See the digestive and stomach medicines hub.
What to check before using Tranexamic Acid
The central question before prescribing is whether you are at increased risk of an unwanted clot, because the medicine works by protecting clots.
Tell your doctor or pharmacist if you:
- Have ever had a blood clot — deep vein thrombosis, pulmonary embolism, stroke or heart attack — or have a clotting disorder that predisposes to them.
- Have a family history of clots at a young age.
- Take the combined oral contraceptive pill or hormone replacement therapy, which themselves raise clot risk slightly.
- Have kidney disease — the dose usually needs reducing.
- Have blood in your urine from a kidney cause, where clot formation in the urinary tract can cause obstruction.
- Have had seizures — high doses, mainly intravenous, have been associated with them.
- Have eye problems affecting colour vision.
- Are pregnant or breastfeeding.
- Are being investigated for irregular bleeding that has not yet been explained.
Take it only during bleeding, as prescribed, and follow the instructions on your pack for how many days. This page does not set doses. Tablets can be taken with or without food.
Importantly: if you are taking it for heavy periods, it treats the symptom. Persistently heavy bleeding still deserves a diagnosis — fibroids, polyps, thyroid problems and clotting disorders are all treatable causes.
Possible cautions and when to ask a pharmacist or doctor
Common side effects are nausea, vomiting, diarrhoea and indigestion, more likely at higher doses and often reduced by taking it with food.
Get emergency help for signs of a blood clot:
- Pain, swelling, warmth or redness in one leg — possible deep vein thrombosis.
- Sudden breathlessness or chest pain, particularly with coughing up blood — possible pulmonary embolism.
- Sudden weakness on one side, facial droop, slurred speech or a severe unusual headache — possible stroke.
Also seek urgent care for swelling of the face or throat, difficulty breathing, or a widespread rash.
Contact your doctor if:
- Bleeding is not reduced after a couple of cycles or courses.
- You notice changes in vision or colour vision.
- Heavy periods are getting worse, or bleeding occurs between periods or after intercourse.
- You are soaking through protection hourly, passing large clots, or feeling faint, breathless or exhausted — these suggest bleeding heavy enough to need assessment for anaemia and its cause.
Bleeding from the digestive tract — vomiting blood, or black tarry stools — is always an emergency, whatever medicine you are on.
Related medicine guides
Frequently asked questions
What is tranexamic acid 500 mg used for? Most commonly heavy menstrual bleeding. It is also used for bleeding after surgery or dental work, nosebleeds, bleeding in the gut, trauma and postpartum haemorrhage.
Is it a blood thinner? No — the opposite. It stops clots breaking down, which reduces bleeding. Anticoagulants prevent clots forming.
Do I take it every day? For heavy periods, it is taken only during the days of bleeding, as prescribed — not continuously.
Does it stop periods? No. It reduces how heavy the bleeding is; it does not stop or delay a period.
Can I take it with the contraceptive pill? Tell your doctor, since both slightly raise clot risk. They may still be used together where the benefit justifies it.
Is it available over the counter? No. It is Schedule 4 in South Africa and requires a prescription.
How quickly does it work? For heavy periods, most people notice a reduction within the first day or two of taking it.