A 35-year-old woman with symptomatic uterine fibroids and heavy menstrual bleeding (Hb 9.8 g/dL) is prescribed tranexamic acid for cycle-related use during menorrhagia. What is the standard oral dose of tranexamic acid for heavy menstrual bleeding?

• A 500 mg once daily during days 1-5 of the cycle
• B 2 g once daily on the heaviest day of bleeding
• C 250 mg twice daily throughout the cycle
• D 1 g three times daily for up to 5 days during menstruation ✓

Explanation

Tranexamic acid 1 g orally three times daily for up to 5 days during menstruation is the standard licensed dose for heavy menstrual bleeding (NICE NG88, FOGSI guidelines). It reduces bleeding by approximately 40-60% through antifibrinolytic action on endometrial plasminogen activator. Option A is subtherapeutic. Option C is not the standard cyclic regimen.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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