Heavy menstrual bleeding, nosebleeds, bleeding after dental extraction in people with clotting problems, and, given in hospital, serious bleeding after trauma, surgery or childbirth. It is used in some countries for skin pigmentation such as melasma, off the standard licence.

When the body forms a clot it also prepares to dissolve it, using an enzyme called plasmin that is made from plasminogen. Tranexamic acid blocks the site on plasminogen that it needs in order to attach to the clot, so the clot that has already formed is left in place long enough for the bleeding to stop. It does not make the blood clot more readily; it stops existing clots breaking down early.

Nausea, vomiting, diarrhoea and stomach discomfort. Given by injection, a fall in blood pressure if it is pushed too quickly.

Not for people with an active clot, or a history of deep vein thrombosis, pulmonary embolism or stroke, and used with caution with hormonal contraception, which also raises clot risk. Report sudden leg pain or swelling, chest pain, breathlessness, or changes in vision. Tell your doctor about kidney disease, which changes the dose, or about blood in the urine. It is a prescription medicine in Pakistan.