it says spill liquid injectable form of 10% tranexamic acid onto a cotton pad and insert it on the affected nostril until bleeding stopped.
it worked very well for me I tried it couple of time .
I will later ask my doctor if there is any limit to this approach ? and comparing the toxicity of oral tranexamic acid vs this approach.
Good info. Thanks. Do you always take tranexamic acid via subq? I only have tablets on hand.
Pinching your nose where the bone and cartilage meet works too, especially if bleeding isn't too bad. If bleeding is persistent it could take hours, as is the case with the other options.
I once asked my hematologist (not my current one) if I could just take tranexamic acid and forget about all the other ITP treatments. haha I thought it would be such an easy, inexpensive solution. Unfortunately, as you wrote, one shouldn't take it regularly.
Diagnosed in 2000, at 59, after being on moderately high doses of NSAIDs for arthritis. Splenectomy and rituxan both failed (2004). Did well on prednisone till summer 2018--then terrible reactions. Promacta since 11-19.
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Diagnosed with ITP in 2000, I have had major nosebleeds since 2011. In 2014, I asked my hema about transexamic acid, and he replied:
" I would not recommend transexamic acid - it is approved for use in patients with hemophilia, not ITP. It has been associated with serious blood clots."
Here are techniques I have used to stop big nosebleeds (the kind that last 5 or more hours):
I have nosepinchers so that I can have free hands sometimes during a bleed. Nosepinchers do not not usually provide enough pressure to stop a bleed, but it is good to be able to use your hands at times. When a bleed starts, I spray my nostrils with decongestant spray like Afrin (this causes capillaries to constrict). Then I spray hemastatic gauze (like BloodStop products) with decongestant spray and insert into my nostrils. I've also used the BloodStop plugs. I apply firm pressure. If the source of the bleed is high, pressure doesn't help much, alas. I use ice on my forehead and the top of my nose as well as on my nostrils. I keep a waterbottle nearby with a straw--important to keep drinking water. I keep my nosebleed kit (pinchers, hemastatic gauze, Afrin) near me at all times.
As soon as possible after a bleed, I contact the head-and-neck people, who cauterize any bad spots they see. Chemical cauterization lasts a while, usually. Electrical cauterization--which is very uncomfortable--produces longer lasting results.
I keep my nostrils moist with products like Aquagel (vaseline okay, but heavier) and nosesprays that aren't solely saline. I also use a steamer to keep my nostrils moist during dry days.
Interesting about tranexamic acid and blood clots. As far as I know it works be preventing the break down of clots, not creating new clots. I'll ask my hemo about it.
I never heard of hemostatic gauze. Sounds really useful for nosebleeds, cuts or other external bleeding.
For me, hemostatic gauze wouldn't help much since I can't very well plug up gastrointestinal or other bleeding with it. Still, good to know about. Thanks
ITP since 2014. Retired nurse. My belief is empower patients to be involved as much as possible in their care. Read, read, read & ALWAYS question medics about the evidence base they use.
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"Tranexamic acid competitively inhibits activation of plasminogen.....thereby reducing conversion of plasminogen to plasmin (fibrinolysin), an enzyme that degrades fibrin clots, fibrinogen, and other plasma proteins, including the procoagulant factors V and VIII. Tranexamic acid also directly inhibits plasmin activity, but higher doses are required than are needed to reduce plasmin formation."
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