Lysteda (Tranexamic Acid) - Oral

What Is Lysteda?

Lysteda (tranexamic acid) is a medication used to treat heavy menstrual bleeding (menorrhagia) in people of reproductive potential. It belongs to a class of drugs called antifibrinolytics.

Tranexamic acid reduces menstrual blood loss by slowing fibrin from being broken down and stabilizing blood clots. Lysteda does not contain any hormones. 

Lysteda is available by prescription as an oral tablet.

Drug Facts

Generic Name: Tranexamic acid

Brand Name(s): Lysteda

Drug Availability: Prescription

Therapeutic Classification: Antifibrinolytic

Available Generically: Yes

Controlled Substance: N/A

Administration Route: Oral

Active Ingredient: Tranexamic acid

Dosage Form(s): Tablet

What Is Lysteda Used For?

The U.S. Food and Drug Administration (FDA) approved Lysteda to treat cyclic heavy menstrual bleeding in females of reproductive potential.

Before beginning medication to treat heavy menstrual bleeding, it is important to see a healthcare provider to diagnose the cause of heavy bleeding, as procedures or surgeries are sometimes needed.

How to Take Lysteda

Follow your healthcare provider’s instructions for taking Lysteda.

Take Lysteda during monthly menstruation (days you are bleeding) for a maximum of five days in a row. If your bleeding stops before five days, discontinue treatment. You may take Lysteda with or without food. Swallow the tablets whole and do not crush, chew, or divide tablets.

Storage

Store the tablets at room temperature (between 68 F and 77 F) and protect them from light and moisture.

Off-Label Uses

Healthcare providers may prescribe tranexamic acid for off-label uses, meaning for conditions not specifically indicated by the FDA.

Tranexamic acid can be used off-label for:

  • Hereditary angioedema
  • Prevention of postoperative bleeding in patients on anticoagulants after tooth extractions
  • Prevention of intracranial rebleeding after recent aneurysmal subarachnoid hemorrhage
  • Intravenous (IV) use for the prevention of bleeding after total hip or knee replacement surgery

How Long Does Lysteda Take to Work?

In clinical trials, those who took Lysteda experienced a one-third decrease in menstrual blood loss compared to their baseline during their first cycle. These results remained consistent throughout the study duration of three to six menstrual cycles.

What Are the Side Effects of Lysteda?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects of Lysteda may include:

  • Headache
  • Nasal and sinus symptoms
  • Back pain
  • Musculoskeletal pain
  • Migraine
  • Anemia
  • Fatigue

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Severe side effects can include the following:

  • Thromboembolic disorder, or pulmonary embolism, which can cause a sudden onset of chest pain or difficulty breathing
  • Anaphylaxis or severe allergic reaction
  • Eye problems, including visual disturbances and blood clots in retinal blood vessels

Long-Term Side Effects

In long-term extensions of clinical trials that spanned nine and 27 menstrual cycles, the side effects observed were similar to those in shorter studies. The percentage of people reporting side effects was greater in the 27-month study, but this was most likely due to the longer study duration.

Report Side Effects

Lysteda may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Lysteda Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • To treat heavy menstrual bleeding:
      • Adults—Two tablets (650 milligrams per tablet) three times a day in the morning, afternoon, and evening. The tablets should not be taken more than 5 days in a row for each monthly period.
      • Children—Use and dose must be determined by your doctor.

Modifications

Lysteda is not indicated for use in pregnancy, and there is no data available on the use of Lysteda in pregnant persons to evaluate risks to the fetus. 

Tranexamic acid is present in human breast milk at a concentration of 1% of the peak blood concentration of a lactating person. One small study compared 21 women who took tranexamic acid while breastfeeding with 42 women in a control group; results showed no difference in safety, growth, and development outcomes for children aged one through three.

The safety and effectiveness of Lysteda in post-menarchal (after the first occurrence of menstruation) adolescents are similar to menstruating adults. Use of Lysteda is not indicated before menarche or after menopause.

Missed Dose

If you miss a dose of Lysteda, take it when you remember, then take the next dose at least six hours later. Do not take more than two tablets at once to make up for a missed dose. 

Overdose: What Happens If I Take Too Much Lysteda?

There are no known cases of intentional overdose with Lysteda. However, based on information regarding tranexamic acid overdoses, Lysteda overdoses should be treated symptomatically.

Overdose symptoms may include:

  • Nausea or vomiting
  • Diarrhea
  • Low blood pressure
  • Blood clots
  • Mental status changes
  • Visual impairment
  • Myoclonus (muscle jerking)
  • Rash

What Happens If I Overdose on Lysteda?

If you think you or someone else may have overdosed on Lysteda, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Lysteda, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress while you are using this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Tell your doctor if you are using birth control pills or other types of birth control (eg, patch, vaginal ring, or intrauterine device). You should not use this medication if you are also using combination hormonal contraception because it may increase your chance of having a blood clot, heart attack, or stroke. Your risk is even higher if you are overweight, if you smoke cigarettes, or if you are over 35 years of age.

This medicine may cause serious allergic reactions including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have shortness of breath, trouble breathing, chest tightness, flushing of the face, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Call your doctor right away if you have any eye problems, such as a change in your vision. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).

If this medicine does not reduce your bleeding after two menstrual cycles or if it seems to stop working, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Lysteda?

Do not take Lysteda if you have:

  • Active thromboembolic disease
  • History of thrombosis (blood clots) or thromboembolism
  • An intrinsic risk of thrombosis or thromboembolism (e.g., hypercoagulopathy)
  • Hypersensitivity to tranexamic acid
  • Current use of combined hormonal contraception (contains estrogen and progestin)

What Other Medications Interact With Lysteda?

Before starting Lysteda, tell your healthcare provider about any other medicines you take or plan to take, including prescriptions, over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.

Lysteda may interact with the following:

  • Hormonal contraceptives that contain estrogen and progestin: You should not take Lysteda with combined hormonal contraceptives due to the increased risk of life-threatening blood clot formation. 
  • Tissue plasminogen activators, which are made of proteins that help dissolve blood clots: Lysteda and tissue plasminogen activators have opposing activity, so using them together may decrease the efficacy of both medications. 
  • Factor IX complex or other anti-inhibitor coagulant concentrates: There is an increased risk of thrombosis when using Lysteda with Factor IX complex or other anti-inhibitor coagulant concentrates. 
  • All-trans retinoic acid (tretinoin), often used for acne and acute promyelocytic leukemia: In people with acute promyelocytic leukemia taking all-trans retinoic acid, Lysteda may increase its blood-coagulating effects.

This is not a complete list of interactions, and others may occur. Talk with your pharmacist or healthcare provider for more detailed information about medication interactions with Lysteda.

What Medications Are Similar?

Lysteda is an antifibrinolytic. Another medication in the same drug class is Amicar (aminocaproic acid), used to treat severe and excessive fibrinolytic bleeding conditions (when blood clots are broken down).

Frequently Asked Questions

  • How does Lysteda work?

    Lysteda decreases heavy menstrual bleeding by blocking the activity of an enzyme that breaks down fibrin in clots. By slowing the breakdown of clots, Lysteda reduces bleeding by about one-third during a menstrual cycle.

  • What side effects can I expect while taking Lysteda?

    The most common side effects of Lysteda reported during clinical trials were headache, nasal/sinus congestion, back pain, muscle pain, and abdominal pain.

  • How much improvement in bleeding should I expect with Lysteda?

    In clinical trials, Lysteda reduced menstrual blood loss volume by about one-third in most people.

  • How long does Lysteda take to work?

    Most people noticed a reduction in bleeding during the first menstrual cycle of use. If you do not see a decrease in blood loss by the end of your second cycle, talk to your healthcare provider about whether you should stop this medication.

How Can I Stay Healthy While Taking Lysteda?

Monitor your menstrual bleeding (e.g., frequency of pad/tampon changes) after starting Lysteda. You should notice a reduction in bleeding during the first cycle of taking this medication. If you do not see an improvement in bleeding after taking Lysteda for two menstrual cycles, follow up with your healthcare provider. 

Lysteda may increase the risk of severe blood clots that can occur in the eye or elsewhere in the body, so seek immediate medical attention for any sudden onset of visual disturbances, such as loss of vision or changes in vision, as well as sudden onset of pain or difficulty breathing. 

Lysteda does not prevent pregnancy, affect fertility, or prevent sexually transmitted infections (STIs). Talk to your healthcare provider about effective contraception that can be used with Lysteda and safer sex practices

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Food and Drug Administration. Lysteda prescribing information.

  2. Costantino G, Casazza G, Bossi I, et al. Long-term prophylaxis in hereditary angio-oedema: a systematic review. BMJ Open. 2012;2(4):e000524. doi:10.1136/bmjopen-2011-000524

  3. Carter G, Goss A. Tranexamic acid mouthwash--a prospective randomized study of a 2-day regimen vs 5-day regimen to prevent postoperative bleeding in anticoagulated patients requiring dental extractions. Int J Oral Maxillofac Surg. 2003;32(5):504-507.

  4. Prescribers' Digital Reference. Tranexamic acid - drug summary.

  5. Ockerman A, Vanassche T, Garip M, et al. Tranexamic acid for the prevention and treatment of bleeding in surgery, trauma and bleeding disorders: a narrative review. Thromb J. 2021;19(1):54. doi:10.1186/s12959-021-00303-9

  6. Tranexamic acid. In: Drugs and Lactation Database (LactMed). National Institute of Child Health and Human Development; 2006.

  7. Gilad O, Merlob P, Stahl B, et al. Outcome following tranexamic acid exposure during breastfeeding. Breastfeed Med. 2014;9(8):407-410. doi:10.1089/bfm.2014.0027

  8. DailyMed. Label: amicar- aminocaproic acid solution, amicar- aminocaproic acid tablet.

By Carrie Yuan, PharmD
Carrie Yuan PharmD is a clinical pharmacist with expertise in chronic disease medication management for conditions encountered in primary care.