Tranexamic acid-also known as hemostatic cyclic acid, coagulant acid, antifibrinolytic cyclic acid, or *trans*-aminomethylcyclohexanecarboxylic acid-is an organic compound with the chemical formula C8H15NO2 and a molar mass of 157.21 g/mol. It appears as a white crystalline powder that is readily soluble in water and glacial acetic acid, yet almost insoluble in ethanol and acetone; the pH of a 5% aqueous solution ranges from 7.0 to 8.0.
Tranexamic acid exhibits characteristic reactions of amino acids: for instance, when an aqueous solution is gently heated with ninhydrin reagent, the solution changes from colorless to blue-violet; it produces an orange-red color upon reaction with ferric chloride reagent.
Okamoto, Yokoi, and their colleagues discovered in 1954 that tranexamic acid possesses the ability to inhibit the activation of plasminogen. Subsequent research by Shimizu et al. in 1963 confirmed that the active component is *trans*-tranexamic acid, while the activity of *cis*-tranexamic acid is merely one-fiftieth that of the *trans* isomer. Production methods for tranexamic acid include the platinum oxidation method and the chloroprene method, among others. Clinically, it is used to treat various forms of hemorrhage caused by hyperfibrinolysis; bleeding resulting from trauma or surgery involving organs rich in plasminogen activators; and fibrinolytic bleeding associated with induced abortion, abruptio placentae, fetal death, and amniotic fluid embolism.
Common adverse reactions to tranexamic acid include gastrointestinal disturbances; overdose may lead to thrombosis or induce myocardial infarction. Women concurrently using contraceptives or estrogen therapy are at a heightened risk of developing thrombotic tendencies, and the drug should be used with caution in patients with renal insufficiency.
As of June 16, 2025-according to statistics compiled by Mosang Pharmaceutical-tranexamic acid has received regulatory approval for market release in various dosage forms, including capsules, tablets, and injectables, with a total of 170 active marketing authorizations currently in force.
