, Volume 14, Issue 3, pp 255-257

High Dose of Tranexamic Acid for Treatment of Severe Menorrhagia in Patients with von Willebrand Disease

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Menorrhagia is one of the most important and frequent complications in women with congenital von Willebrand disease (vWD). Three cases of menorrhagia with vWD (type 1; 1 case, type 2A; 2 cases) were successfully treated with tranexamic acid at dose of 3 grams daily in four divided doses for the first 5 days of the menstrual cycle. All patients had severe menorrhagia lasted for more than 10 days with iron deficiency anemia of hemoglobin levels of 6.5–8.4 g/dl. Common dosage of tranexamic acid of 1 gram daily in 4 divided doses on days 1–5 of their menstrual cycles did not correct their menorrhagia. The treatment was then changed to the daily dose of 3 grams in 4 divided doses on days 1–5 of their menstrual cycles. Thereafter, their menorrhagia became well-controlled with improvement of their anemia up to hemoglobin of 11.5–12.4 g/dl. High dose of tranexamic acid has been administered safely in all patients for 3–5 years without significant complications. Oral high-dose administration of tranexamic acid is very convenient and useful for treatment of menorrhagia in the patients with vWD.