Comprehensive medication guide to Tranexamic Acid including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay on most commercial and Medicare Part D plans; listed as Tier 3 on most Medicare formularies with no prior authorization required for the FDA-approved heavy menstrual bleeding indication.
Estimated Cash Pricing
$27–$30 with GoodRx or SingleCare coupons for a 30-day supply (30 × 650 mg tablets); retail price averages $127 without a coupon. Mark Cuban Cost Plus Drugs also offers competitive pricing with home delivery.
Medfinder Findability Score
78/100
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Tranexamic acid (TXA) is a prescription antifibrinolytic medication that prevents excessive bleeding by stopping blood clots from breaking down too quickly. First synthesized in 1962 by Japanese researchers Shosuke and Utako Okamoto, it is now on the World Health Organization's List of Essential Medicines and is used across numerous medical specialties worldwide.
It is FDA-approved for two indications: treating heavy menstrual bleeding (as oral tablets, 1,300 mg three times daily for up to 5 days per cycle), and reducing hemorrhage in hemophilia patients during dental extractions (IV injection). Off-label, it is widely used for major trauma, postpartum hemorrhage, surgical blood conservation, von Willebrand disease, and hereditary angioedema.
The brand-name Lysteda was discontinued in 2020. Generic tranexamic acid 650 mg tablets from manufacturers including Amring Pharmaceuticals, Teva, and ANI Pharmaceuticals are currently available. It is not a hormone and not a controlled substance.
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Tranexamic acid is a synthetic analog of the amino acid lysine. It works by competitively binding to the lysine-binding sites on plasminogen (4–5 sites per molecule). This prevents plasminogen from attaching to fibrin — a necessary step before plasminogen can be converted to plasmin, the enzyme that dissolves blood clots. By blocking this conversion, TXA preserves fibrin clot structure and reduces bleeding.
This mechanism — antifibrinolysis — explains why TXA is effective in the uterus (which has high natural fibrinolytic activity during menstruation), in trauma (where shock triggers hyperfibrinolysis), and during surgery (where tissue damage activates clot breakdown). TXA is approximately 8 times more potent than the older antifibrinolytic aminocaproic acid (Amicar), which works by the same mechanism.
At higher concentrations, TXA also directly inhibits plasmin activity and can block urokinase plasminogen activator (uPA). By reducing plasmin activity, it additionally decreases complement activation, which may explain its benefit in hereditary angioedema (HAE). Oral tranexamic acid has a half-life of approximately 11 hours and is primarily eliminated unchanged by the kidneys.
650 mg — oral tablet
Standard oral dose for heavy menstrual bleeding. Take 2 tablets (1,300 mg) three times daily for up to 5 days during menstruation.
100 mg/mL — IV injection
Injectable formulation for hospital use in hemophilia (dental extraction) and off-label uses including trauma and surgical hemostasis.
As of 2026, tranexamic acid oral tablets are not on the FDA's official Drug Shortages database. Multiple generic manufacturers supply the U.S. market, giving the supply chain reasonable stability. However, localized stock gaps at retail pharmacies are common — particularly at smaller locations — because demand is cyclical (monthly cycle refills) and some pharmacies don't maintain large buffer stocks.
Patients using tranexamic acid each month should refill their prescription 7–10 days before their expected period starts. Consider a 90-day mail-order supply to eliminate monthly retail availability uncertainty. If your usual pharmacy is out of stock, note that availability varies significantly between chains and even between locations of the same chain.
If you're having trouble locating tranexamic acid, medfinder calls pharmacies near you to find out which ones currently have it in stock, then sends you the results by text.
Tranexamic acid is not a controlled substance, so it can be prescribed by any licensed healthcare provider with prescribing authority. No special DEA registration is required. Providers who commonly prescribe tranexamic acid include:
OB/GYNs: Most common prescribers for heavy menstrual bleeding; can evaluate for underlying structural or hormonal causes
Primary Care Physicians (PCPs): Family medicine and internal medicine physicians commonly manage HMB with tranexamic acid
Hematologists: Specialists for bleeding disorders (hemophilia, VWD, platelet function disorders)
Pediatricians: For adolescent heavy menstrual bleeding or pediatric bleeding disorders
Nurse Practitioners and Physician Assistants: Advanced practice providers in women's health, primary care, and hematology practices
Emergency Medicine Physicians and Surgeons: For IV TXA in trauma, surgery, and acute hemorrhage
Telehealth providers can also prescribe tranexamic acid for heavy menstrual bleeding through same-day video visits on platforms like Sesame Care. This is particularly convenient for patients who need a prescription quickly or live in areas with limited specialist access.
No. Tranexamic acid is not a DEA-scheduled controlled substance. It does not have any abuse or dependence potential. This means it can be prescribed by any licensed healthcare provider — including physician assistants, nurse practitioners, and telehealth providers — without any special DEA registration requirements.
Unlike opioids or stimulants, tranexamic acid does not require in-person visits for refills, is not subject to quantity limitations under controlled substance laws, and can be called in, electronically prescribed, or sent to mail-order pharmacies across state lines (subject to state licensing requirements). Patients can fill it at any licensed pharmacy without restrictions.
At oral doses used for heavy menstrual bleeding, tranexamic acid is generally well-tolerated. Common side effects include:
Nausea (most common; take with food to reduce)
Headache
Back pain
Abdominal pain or stomach discomfort
Diarrhea or vomiting
Dizziness (do not drive if dizzy)
Serious side effects requiring immediate medical attention:
Venous or arterial thromboembolism (DVT, PE, stroke, retinal vein/artery occlusion)
Seizures (primarily with IV use, especially inadvertent neuraxial injection — 2025 FDA Boxed Warning)
Visual disturbances or color vision changes (retinal toxicity at high doses)
Severe allergic reaction / anaphylaxis (hives, throat swelling, difficulty breathing)
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Aminocaproic Acid (Amicar)
Most direct antifibrinolytic substitute — same drug class and mechanism. Approximately 6-10x less potent than TXA; higher dose required. Available as oral tablets (500 mg, 1000 mg) and IV.
Desmopressin (DDAVP / Stimate)
Synthetic vasopressin analog. Best for mild hemophilia A and von Willebrand disease (types 1, 2A, 2M, 2N) in DDAVP-responsive patients. Not effective for standard HMB without underlying coagulation disorder.
Levonorgestrel IUD (Mirena / Liletta)
Highly effective long-term option for heavy menstrual bleeding — reduces HMB by >90% in many patients. Requires provider insertion; not a pharmacological substitute.
NSAIDs (ibuprofen, naproxen)
Reduce prostaglandin-driven menstrual blood loss by ~20-30% and relieve dysmenorrhea. OTC option for mild HMB; not appropriate for patients with platelet function disorders.
Combined Oral Contraceptives
Hormonal option that reduces HMB by 40-50% on average. Contraindicated in combination with TXA due to increased clot risk. Not appropriate for patients with thromboembolic history.
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Factor IX concentrates / Prothrombin complex concentrates (Kcentra)
majorContraindicated combination — greatly increases risk of arterial and venous thrombosis.
Anti-inhibitor coagulant complex (FEIBA)
majorAvoid or use with extreme caution — pharmacodynamic synergism significantly increases thromboembolism risk.
Estrogen-containing hormonal contraceptives (combined pill, patch, ring)
moderateNot recommended — both agents increase clot risk via different mechanisms; combination raises DVT/PE risk meaningfully.
Defibrotide (Defitelio)
moderateTXA may reduce defibrotide efficacy via pharmacodynamic antagonism (pro-fibrinolysis vs. antifibrinolysis).
Anticoagulants (warfarin, apixaban, rivaroxaban)
moderatePartial pharmacodynamic opposition; requires careful medical assessment before combining. Not absolutely contraindicated but must be clinician-supervised.
Tranexamic acid is one of the most versatile and evidence-backed hemostatic agents in modern medicine — from reducing battlefield casualties to treating heavy menstrual bleeding in millions of patients worldwide. Its inclusion on the WHO's Essential Medicines List reflects its clinical importance. As a non-hormonal, non-controlled prescription medication, it is broadly accessible to patients through any licensed healthcare provider.
Despite the 2020 discontinuation of brand-name Lysteda, generic tranexamic acid is readily available from multiple manufacturers at significantly reduced cost — as low as $27-$30 with GoodRx or SingleCare. No national shortage exists in 2026, though localized pharmacy stock gaps can occur. Patients should refill early, consider 90-day mail-order supplies, and know that aminocaproic acid (Amicar) is the most pharmacologically direct alternative if TXA is temporarily unavailable.
If you're having difficulty locating tranexamic acid at your local pharmacy, medfinder can help by calling pharmacies near you to confirm which ones can fill your prescription — saving you the frustration of an empty-shelf trip.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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