Nimra (Tranexamic Acid)

• Tranexamic Acid acts as an antifibrinolytic to reduce excessive bleeding in several clinical settings.
• Menorrhagia: reduces the volume of menstrual blood loss in women with heavy periods.
• Traumatic or surgical bleeding: stabilises clots to limit peri‑operative or injury‑related hemorrhage.
• Hereditary angioedema prophylaxis: decreases frequency and severity of swelling attacks by limiting fibrinolysis.

• Tranexamic Acid competitively inhibits the activation of plasminogen to plasmin by binding to lysine‑binding sites on plasminogen. This blocks fibrin degradation, preserves clot integrity, and reduces bleeding. The effect is dose‑dependent and reversible, allowing normal hemostasis to resume once the drug is cleared.

Tranexamic Acid is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Nausea or vomiting
• Diarrhoea or abdominal discomfort
• Headache or dizziness
• Fatigue or weakness
• Nasal congestion or epistaxis
• Mild skin rash

Serious or Rare Side Effects

• Thromboembolic events (deep‑vein thrombosis, pulmonary embolism)
• Visual disturbances (blurred vision, retinal artery occlusion)
• Severe allergic reactions (anaphylaxis, angioedema)
• Hypotension or circulatory collapse
• Seizures (especially in renal impairment)
• Severe hepatic dysfunction

• Before prescribing Tranexamic Acid, clinicians should consider several safety measures.
• Assess thrombotic risk: evaluate history of clotting disorders before use.
• Monitor renal function: adjust dose or avoid in severe renal impairment.
• Use caution in pregnancy: limited data, weigh benefits against potential risks.
• Avoid in active intravascular clot: contraindicated when a clot is present.
• Review concomitant anticoagulants: monitor for altered bleeding or clotting.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct sunlight.

Tranexamic Acid can interact with other medicines that affect coagulation or hemostasis.

Major Interactions (Avoid)

• Concurrent thrombolytic therapy (e.g., alteplase): increased risk of thrombosis.
• Combined use with hormonal contraceptives in high‑risk patients: may potentiate clot formation.
• Other potent pro‑coagulants (e.g., activated factor VII): heightened thrombotic potential.

Moderate Interactions (Monitor Closely)

• Anticoagulants (warfarin, direct oral anticoagulants): may require INR or clotting parameter monitoring.
• Antiplatelet agents (aspirin, clopidogrel): monitor for unexpected bleeding or clotting.
• NSAIDs or selective serotonin reuptake inhibitors: increased bleeding tendency, observe for gastrointestinal symptoms.