Patients with irregular menstrual bleeding should not use tranexamic acid until the cause of the irregularity has been established. If menstrual bleeding is not adequately reduced by tranexamic acid, an alternative treatment should be considered. Patients with a high risk for thrombosis (a previous thromboembolic event and a family history of thromboembolic disease) should not use tranexamic acid only if there is a strong medical indication and under strict medical supervision.
Use in pregnancy: Although there is no evidence from animal studies of teratogenic effect, the usual caution with the use of drugs in pregnancy should be observed.
Use in lactation: Tranexamic acid is excreted into breastmilk, but it is not likely to influence the child at therapeutic doses.
Use in children: Clinical experience with tranexamic acid in menorrhagic children <15 years is not available.
Use in the elderly: No reduction in dosage is necessary unless there is evidence of renal failure.