Trauma-associated hemorrhage and coagulopathy remain leading causes of mortality. Such coagulopathy often leads to a hyperfibrinolytic phenotype where hemostatic clots become unstable because of upregulated tissue plasminogen activator (tPA) activity. Tranexamic acid (TXA)， a synthetic inhibitor of tPA， has emerged as a promising drug to mitigate fibrinolysis. TXA is US Food and Drug Administration-approved for treating heavy menstrual and postpartum bleeding， and has shown promise in trauma treatment. However， emerging reports also implicate TXA for off-target systemic coagulopathy， thromboembolic complications， and neuropathy.
Trauma-associated hemorrhage and coagulopathy remain leading causes of mortality. Such coagulopathy often leads to a hyperfibrinolytic phenotype where hemostatic clots become unstable because of upregulated tissue plasminogen activator (tPA) activity. Tranexamic acid (TXA)， a synthetic inhibitor of tPA， has emerged as a promising drug to mitigate fibrinolysis. TXA is US Food and Drug Administration-approved for treating heavy menstrual and postpartum bleeding， and has shown promise in trauma treatment. However， emerging reports also implicate TXA for off-target systemic coagulopathy， thromboembolic complications， and neuropathy.
