The antifibrinolytic drug tranexamic acid (TXA) is best known for preoperative prophylaxis to prevent haemorrhage during and after surgery, and for treating excessive blood loss in women with heavy menstrual periods. It is also likely to be effective in another context — to prevent deaths from bleeding after trauma, according to an updated Cochrane Database review. A systematic review in 2004 of randomised trials in which TXA was given to patients with bleeding following severe injury was inconclusive, but two trials of TXA have been conducted since then. The 2011 review shows that TXA reduces the risk of death from bleeding by 10%-15% compared with patients who receive no treatment with TXA, without causing adverse events.
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