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Table 1 TXA doses found to be beneficial regarding bleeding outcomes for various indications

From: Tranexamic acid for the prevention and treatment of bleeding in surgery, trauma and bleeding disorders: a narrative review

Indication Patient Recommended TXA dose References
Epistaxis Regular PERI 1% soaked pledgets or sprayed [16,17,18]
Menorrhagia Regular or bleeding disorder PERI 2-4 g/d (max. 5 d) [19]
Trauma Regular PRE 1 g (over 10 min) [20]
PERI 1 g (over 8 h)
Postpartum hemorrhage Regular PRE 1 g (over 10 min) [21]
POST 1 g if bleeding continuous after 30 min or if bleeding restarts after 24 h
Myomectomy and hysterectomy Regular (A) PRE 10-15 mg/kg [22,23,24,25,26]
PERI (optional) 1 mg/kg/h (continuous) [23, 24]
Regular (B) PERI 2 g soaked gauzes [24, 26]
Orthopedic Regular PRE 10-15 mg/kg (max 1.2 g, over 30 min) [27, 28]
PERI (optional) 1-3 g diluted in 30-100 mL NS (topical with closure) [27,28,29,30]
POST 10-15 mg/kg (after 3 hours or via infusion), optionally repeated [27, 28, 31,32,33,34,35]
Cardiac surgery Low bleeding risk PRE 10-15 mg/kg [36]
PERI 1 mg/kg/h continuous infusion (6-8 hours)
High bleeding risk PRE 30 mg/kg
PERI 16 mg/kg/h continuous infusion (6-8 hours)
Maxillofacial surgery Regular (A) PRE 10-20 mg/kg [37,38,39]
Regular (B) PERI 1% irrigation
Minor oral surgery Anticoagulant or bleeding disorders PERI (optional) 5% irrigation [40, 41]
POST 10 mL 5% mouthwash (4x/d for 2-7 d) [40,41,42,43]
Bleeding disorders (A) POST 15-25 mg/kg or 1-1.5 g 2-3x/d [42, 43]
Bleeding disorders (B) PRE 10 mg/kg
POST (optional) 10 mg/kg 3-4x/d
(Adeno) tonsillectomy Regular (A) PRIOR 10 mg/kg [44, 45]
POST (optional) 250 mg 3x/d for 1d and 500 mg 1x/d for 2 d
Regular (B) POST 4% irrigation
Rhinoplasty Regular (A) PRE 10 mg/kg [46]
Regular (B) PRE 1 g
POST (optional) 1g 3x/d (up to 5 d)
Liver transplantation and resection Regular PERI 10-40 mg/kg/h [47, 48]
Prostate surgery Regular (A) PERI 2 g 3x/d [49, 50]
POST 2 g 3x/d (first postoperative day)
Regular (B) PERI 1 g diluted in 200 mL NS or 10 mg/kg for 0.5 h
Regular (C) PRE 500 mg injection
PERI 250 mg/h
Regular (D) PRE 500 mg injection
POST 500 mg injection
Regular (E) PERI 500 mg irrigation
Nephrolithotomy Regular (A) PRE 1 g [51, 52]
POST 500 mg 3x/d for 1 d
Regular (B) PERI 0.1% irrigation
Melasma Regular (A) PERI 40-500 mg/d 2 x/d (for 12 weeks) [53,54,55]
Regular (B) PERI 10% topical or with microneedling 2 x/d (for 12 weeks)
Mohs micrographic surgery Regular PERI 100-600 mg subcutaneous [56]
Burn wounds or skin grafting Regular PRE 15 mg/kg
  1. with d day(s), min minutes, h hours, pre preoperative dose, peri perioperative dose, post postoperative dose, NS normal saline, = oral dose, = intravenous dose, = topical administration or irrigation, = mouthwash. (A), (B), (C), (D) and (E) are different dose regimen options of TXA for the same indication