Drug Interactions between Provera and tranexamic acid

CONTRAINDICATED: There are no clinical data on the use of tranexamic acid in combination with hormonal contraceptives. Because tranexamic acid is an antifibrinolytic agent, concomitant use may further exacerbate the risk of thrombotic events, including venous thromboembolism as well as arterial thromboses such as stroke and myocardial infarction, associated with hormonal contraceptives. The risk is of particular concern in women who are obese or cigarette smokers, especially smokers over the age of 35. Women using hormonal contraception were generally excluded from clinical trials supporting the safety and efficacy of tranexamic acid for the treatment of menorrhagia (heavy menstrual bleeding). However, there have been postmarketing reports of venous and arterial thrombotic events in women who have used tranexamic acid during treatment with combination hormonal contraceptives.

MANAGEMENT: Due to the potential for increased risk of thrombosis in women receiving hormonal contraceptives, the use of tranexamic acid for the treatment of menorrhagia in this population is considered contraindicated. Patients receiving hormonal contraceptives should be advised to seek medical attention immediately if they experience potential signs and symptoms of blood clots such as chest pain, shortness of breath, hemoptysis, hematuria, sudden loss of vision, and pain, redness or swelling in an extremity.

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