Drug for heavy periods could save lives in accidents by stopping bleeding

An inexpensive drug frequently used to slow bleeding by women with heavy periods can save lives by limiting bleeding after accidents or in war wounds, researchers reported this week. Those given the drug, called tranexamic acid, were at least 10% less likely to die, according to major studies, said researchers from the Cochrane Collaboration, which carries out systematic reviews of the effectiveness of various drugs and medical treatments.

For people age 5 to 45, trauma is second only to HIV/AIDS as a source of death worldwide, with about 3 million people dying from it each year, many after reaching the hospital. Among those who do reach the hospital, about half die from exsanguination -- bleeding out -- in some settings. Central nervous system injury and multiple organ failure account for most of the remainder, and both of those can be exacerbated by severe bleeding.

Tranexamic acid, commonly abbreviated TXA, is a derivative of the amino acid lysine. It is marketed in the United States in tablet form as Lysteda and in intravenous form as Cyklokapron. It is an antifibrinolytic: that is, it halts bleeding by preventing blood clots from breaking down. Other antifibrinolytics include aprotinin and epsilon-aminocaproic acid.

Dr. Ian Roberts of the London School of Hygiene & Tropical Medicine and his colleagues reviewed the medical literature on TXA on behalf of the Cochrane Collaboration. They reported in the Cochrane Database of Systematic Reviews that studies before 2004 gave mixed results on the drug’s effectiveness, but that two newer clinical trials were quite conclusive. One trial looked at 240 patients who were bleeding from a brain injury, while the second looked at 20,211 people who were bleeding from any type of injury. Overall, those given TXA were 10% less likely to die than those given a placebo. That translates to 70,000 lives saved if the drug were used around the world, the authors said. The trial was carried out in several different countries and under many types of conditions, suggesting that the drug would be useful everywhere, they found.

“TXA reduces the risk of a patient bleeding to death following an injury and appears to have few side effects,” Roberts said in a statement. “It could save lives in both civilian and military settings.”