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1、TranexamicacidAreviewofitsuseinthemanagementofmenorrhagia.Tranexamicacid(Transamin,Cyklokapron,Exacyl,Cyklo-f)isasyntheticlysinederivativethatexertsitsantifibrinolyticeffectbyreversiblyblockinglysinebindingsitesonplasminogenandthuspreventingfibrindegradatio
2、n.Inanumberofsmallclinicalstudiesinwomenwithidiopathicmenorrhagia,tranexamicacid2-4.5g/dayfor4-7daysreducedmenstrualbloodlossby34-59%over2-3cycles,significantlymoresothanplacebo,mefenamicacid,flurbiprofen,etamsylateandorallutealphasenorethisteroneatclinical
3、lyrelevantdosages.Intrauterineadministrationoflevonorgestrel20mcg/day,however,producedthegreatestreduction(96%after12months)inbloodloss;44%ofpatientstreatedwithlevonorgestreldevelopedamenorrhea.Tranexamicacid1.5gthreetimesdailyfor5daysalsosignificantlyreduc
4、edmenstrualbloodlossin14womenwithintrauterinecontraceptivedevice-associatedmenorrhagiacomparedwithdiclofenacsodium(150mginthreedivideddosesonday1followedby25mgthreetimesdailyondays2-5)orplacebo.Tranexamicacid,mefenamicacid,etamsylate,flurbiprofenordiclofena
5、csodiumhadnoeffectonthedurationofmensesinthestudiesthatreportedsuchdata.Inalargenoncomparative,nonblind,quality-of-lifestudy,81%ofwomenweresatisfiedwithtranexamicacid3-6g/dayfor3-4days/cycleforthreecycles,and94%judgedtheirmenstrualbloodlosstobe‘decreased’or
6、‘stronglydecreased’comparedwithuntreatedmenstruations.Themostcommonlyreporteddrug-relatedadverseeventsaregastrointestinalinnature.Thetotalincidenceofnausea,vomiting,diarrhoeaanddyspepsiainadouble-blindstudywas12%inpatientswhoreceivedtranexamicacid1gfourtime
7、sdailyfor4daysfortwocycles(notsignificantlydifferenttotheincidenceinplaceborecipients).14Inconclusion,theoralantifibrinolyticdrugtranexamicacidisaneffectiveandwelltoleratedtreatmentforidiopathicmenorrhagia.Inclinicaltrials,tranexamicacidwasmoreeffectiveatre
8、ducingmenstrualbloodlossthanmefenamicacid,flurbiprofen,etamsylateandorallutealphasenorethisterone.Althoughitwasnotaseffectiveasintrauterineadministrationoflevonorgestrel,thehighincidenceofamenorrhoeaan
