Antifibrinolytics - Tranexaminic acid
Tranexamic acid slows down fibrinolysis as a competitive inhibitor of plasminogen activation. Tranexamic acid helps stabilizing the clot by inhibition of the conversion of plasminogen into plasmin; specifically by inhibiting the binding of plasmin onto the fibrin. It also increases collagen synthesis, which preserves the fibrin matrix and increases the strength of the clot.
Tranexamic acid is used to prevent and/or reduce blood loss in many gynaecologic pathophysiologies such as dysfunctional uterine bleeding, menorrhagia, amputation of the cervix and vaginal surgery. In obstetrics, it is applied in case of post partum and ante partum hemorrhage. Tranexamic acid is also indicated for the prevention of bleedings after surgery.
The adverse effects are mainly limited to nausea, vomiting, and diarrhea. Allergy occurs occasionally. There is a theoretical risk of an increased thrombotic tendency, like deep vein thrombosis, during prolonged treatment as with any fibrinolysis inhibitors.