Last update Sept. 23, 2023

Tranexamic Acid

Compatible

Safe substance and/or breastfeeding is the best option.

Anti-fibrinolytic drug that is used on the treatment and prophylaxis of hereditary angioedema, menorrhagia and other hemorrhagic disorders. Oral and intravenous administration.

It is excreted into breast milk in undetectable or clinically insignificant amount; concentration measured in milk is 1% of plasma concentration. (Ahmadzia 2021, Caballero 2012, Pfizer 2011, AEMPS 2010, WHO 2010, Verstraeten 1985) 

Despite of that low observed concentration, an expert consensus did not recommend its use while breastfeeding. (Caballero 2012)

No clinical or developmental issues have been observed in the short and long term among 21 infants whose mothers were treated with it. (Gilad 2014, Shakur 2010)

Scientific societies and some consensus of experts believe it is compatible the use of Tranexamic acid during breastfeeding. (Yeich 2023, Hawke 2016, Bouillet 2015, WHO 2010), although some consider complement C1 esterase inhibitor to be more indicated in cases of hereditary angioedema. (Yeich 2023)

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Tranexamic Acid is also known as


Tranexamic Acid in other languages or writings:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 30 - 50 %
Molecular weight 157 daltons
Protein Binding 3 %
VD 0.18 - 0.39 l/Kg
pKa 4.56 -
Tmax 2.5 hours
2 - 11 hours
M/P ratio 0.01 -
Theoretical Dose < 0.009 - 0.071 mg/Kg/d
Relative Dose < 1.4 %

References

  1. Yeich A, Elhatw A, Ashoor Z, Park K, Craig T. Safety of medications for hereditary angioedema during pregnancy and lactation. Expert Opin Drug Saf. 2023 Jan;22(1):17-24. Consulted on Sept. 22, 2023 Abstract
  2. Ahmadzia HK, Luban NLC, Li S, Guo D, Miszta A, Gobburu JVS, Berger JS, James AH, Wolberg AS, van den Anker J. Optimal use of intravenous tranexamic acid for hemorrhage prevention in pregnant women. Am J Obstet Gynecol. 2021 Jul;225(1):85.e1-85.e11. Abstract Full text (link to original source)
  3. Hawke L, Grabell J, Sim W, Thibeault L, Muir E, Hopman W, Smith G, James P. Obstetric bleeding among women with inherited bleeding disorders: a retrospective study. Haemophilia. 2016 Nov;22(6):906-911. Abstract
  4. Bouillet L, Lehmann A, Gompel A, Boccon-Gibod I, Launay D, Fain O; CREAK.. Traitements des angiœdèmes héréditaires : recommandations du centre de référence national des angiœdèmes (consensus 2014 de Bordeaux). [Hereditary angiœdema treatments: Recommendations from the French national center for angiœdema (Bordeaux consensus 2014)]. Presse Med. 2015 Abstract
  5. Gilad O, Merlob P, Stahl B, Klinger G. Outcome following tranexamic acid exposure during breastfeeding. Breastfeed Med. 2014 Abstract
  6. Caballero T, Farkas H, Bouillet L, Bowen T, Gompel A, Fagerberg C, Bjökander J, Bork K, Bygum A, Cicardi M, de Carolis C, Frank M, Gooi JH, Longhurst H, Martínez-Saguer I, Nielsen EW, Obtulowitz K, Perricone R, Prior N; C-1-INH Deficiency Working Group.. International consensus and practical guidelines on the gynecologic and obstetric management of female patients with hereditary angioedema caused by C1 inhibitor deficiency. J Allergy Clin Immunol. 2012 Abstract Full text (link to original source) Full text (in our servers)
  7. Pfizer. Tranexamic acid (Cyklokapron). Drug Summary. 2011 Full text (in our servers)
  8. AEMPS. Ácido Tranexámico (Amchafibrin) Ficha técnica. 2010 Full text (in our servers)
  9. Shakur H, Elbourne D, Gülmezoglu M, Alfirevic Z, Ronsmans C, Allen E, Roberts I. The WOMAN Trial (World Maternal Antifibrinolytic Trial): tranexamic acid for the treatment of postpartum haemorrhage: an international randomised, double blind placebo controlled trial. Trials. 2010 Abstract
  10. WHO. 18th Expert Committee on the Selection and Use of Essential Medicines. Tranexamic acid. WHO EML. 2010 Full text (link to original source) Full text (in our servers)
  11. Verstraete M. Clinical application of inhibitors of fibrinolysis. Drugs. 1985 Abstract
  12. Pilbrant A, Schannong M, Vessman J. Pharmacokinetics and bioavailability of tranexamic acid. Eur J Clin Pharmacol. 1981 Abstract

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