Cyklonova (Tranexamic Acid)
Antifibrinolytic medicine for heavy menstrual bleeding
Quick Facts About Cyklonova
Key Takeaways About Cyklonova
- Reduces menstrual bleeding by 40–50%: Tranexamic acid is a proven first-line treatment for heavy menstrual bleeding, supported by Cochrane systematic reviews
- Short treatment course: Typically taken for only 3–4 days each menstrual cycle, starting when bleeding begins
- Do not use with active blood clots: Cyklonova is contraindicated in patients with active thromboembolic disease, severe renal impairment, or history of seizures
- WHO Essential Medicine: Tranexamic acid is on the WHO Model List of Essential Medicines, confirming its global importance in healthcare
- Consult your doctor about interactions: Concurrent use with anticoagulants requires specialist supervision to avoid serious complications
What Is Cyklonova and What Is It Used For?
Cyklonova is an antifibrinolytic medicine containing tranexamic acid 500 mg. It works by inhibiting the enzyme that breaks down blood clots (plasmin), thereby reducing blood loss. It is primarily prescribed for heavy menstrual bleeding (menorrhagia).
Cyklonova belongs to a class of medicines known as antifibrinolytics. The active substance, tranexamic acid, is a synthetic amino acid derivative that competitively blocks the lysine-binding sites on plasminogen, the precursor of the enzyme plasmin. Plasmin is responsible for breaking down fibrin, the protein that forms the structural framework of blood clots. By preventing the conversion of plasminogen to plasmin, tranexamic acid stabilizes blood clots and reduces bleeding.
The primary indication for Cyklonova is the treatment of heavy menstrual bleeding, also known as menorrhagia. Heavy menstrual bleeding is defined by the International Federation of Gynecology and Obstetrics (FIGO) as excessive menstrual blood loss that interferes with a woman's physical, emotional, social, and material quality of life. It affects approximately 10–30% of women of reproductive age worldwide, according to the World Health Organization.
Clinical trials and systematic reviews, including those published in the Cochrane Database, have demonstrated that tranexamic acid reduces menstrual blood loss by approximately 40–50% compared to placebo. This makes it one of the most effective non-hormonal treatments available for menorrhagia. The National Institute for Health and Care Excellence (NICE) in the United Kingdom and other international guidelines recommend tranexamic acid as a first-line pharmacological treatment option for heavy menstrual bleeding.
While Cyklonova is specifically indicated for menorrhagia, tranexamic acid as a substance has a much broader range of clinical applications. In injectable and infusion formulations, it is used to control bleeding during and after surgery (particularly cardiac, orthopedic, and obstetric procedures), in trauma-related hemorrhage, dental procedures in patients with bleeding disorders, and hereditary angioedema. The landmark CRASH-2 trial, published in The Lancet, demonstrated that early administration of tranexamic acid significantly reduces mortality in trauma patients with significant hemorrhage.
Tranexamic acid is available under many different brand names worldwide, including Cyklonova, Tranexkabi, Statraxen, Pilexam, Nexag, Tranexamic acid Accord, and Tranexamic acid Stragen. All contain the same active ingredient and work in the same way. The choice of brand typically depends on local availability and prescribing preferences.
What Should You Know Before Taking Cyklonova?
Before taking Cyklonova, inform your doctor if you have a history of blood clots, kidney disease, seizures, or irregular menstrual bleeding. Do not use Cyklonova if you are currently being treated for thromboembolic disease, have severe kidney impairment, or have a history of convulsions.
As with all prescription medications, it is essential to discuss your medical history thoroughly with your healthcare provider before starting Cyklonova. Certain conditions and circumstances require careful evaluation, as the benefits of treatment must be weighed against potential risks. The following sections outline the key considerations.
Contraindications
You should not use Cyklonova if any of the following apply to you:
- Allergy to tranexamic acid: If you are allergic to tranexamic acid or any other ingredient in this medicine (see the Ingredients section below)
- Active thromboembolic disease: If you are currently being treated for blood clots, such as deep vein thrombosis (DVT), pulmonary embolism (PE), or cerebral thrombosis
- Severe renal impairment: If you have severe kidney disease, as tranexamic acid is primarily eliminated through the kidneys and can accumulate to toxic levels
- History of seizures (convulsions): Tranexamic acid can lower the seizure threshold and has been associated with convulsions, particularly at high doses or in patients with a seizure history
- Subarachnoid hemorrhage: Active bleeding in the brain (subarachnoid hemorrhage) is an absolute contraindication due to the risk of cerebral edema and ischemia
Warnings and Precautions
Talk to your doctor, pharmacist, or nurse before using Cyklonova in the following situations:
- Irregular menstrual bleeding: The underlying cause of irregular periods should be investigated before starting treatment with Cyklonova. Irregular bleeding may be a symptom of conditions that require different treatment approaches
- History of blood clots or family history of thrombosis: If you or close family members (parents, siblings) have had blood clots, you may be at increased risk of thromboembolic events while taking tranexamic acid
- Blood in urine (hematuria): Bleeding from the upper urinary tract may lead to clot formation in the ureter or renal pelvis if tranexamic acid is used, potentially causing obstruction
- Reduced kidney function: Dose adjustments are necessary in patients with mild to moderate renal impairment, as tranexamic acid is predominantly excreted by the kidneys
- Combined hormonal contraceptives: Women taking combined oral contraceptives have an inherently increased risk of thromboembolic events. The concurrent use of tranexamic acid may further increase this risk
There is limited clinical experience with Cyklonova in children and adolescents under 15 years of age with heavy menstrual bleeding. If you are under 15, consult your doctor before starting treatment.
If you experience any signs or symptoms of a blood clot while taking Cyklonova – such as sudden shortness of breath, chest pain, leg swelling or pain, sudden visual disturbances, or slurred speech – stop taking the medication immediately and seek emergency medical care. These symptoms may indicate a serious thromboembolic event requiring urgent treatment.
Pregnancy and Breastfeeding
Cyklonova is specifically indicated for heavy menstrual bleeding and is not intended for use during pregnancy or breastfeeding. If you are pregnant, breastfeeding, think you may be pregnant, or are planning to have a baby, consult your healthcare provider before using this medicine.
Tranexamic acid crosses the placental barrier and is excreted in breast milk at concentrations approximately one hundredth of the corresponding serum concentration. While animal studies have not shown direct harmful effects on fetal development, the safety of tranexamic acid during pregnancy has not been established through adequate controlled clinical trials in humans. The European Medicines Agency (EMA) advises caution and recommends that the potential benefits must clearly outweigh the risks before tranexamic acid is used during pregnancy.
Driving and Operating Machinery
Side effects such as dizziness have been reported with tranexamic acid, which may impair your ability to drive or operate machinery safely. You should assess your own ability to perform these activities and exercise caution, especially when first starting treatment. If you experience dizziness or visual disturbances, avoid driving until the symptoms resolve.
How Does Cyklonova Interact with Other Drugs?
Cyklonova should be used with extreme caution alongside anticoagulants (blood thinners) such as warfarin or heparin. Concurrent use with combined hormonal contraceptives may increase the risk of blood clots. Always inform your healthcare provider about all medications you are taking.
Drug interactions can alter the way medications work or increase the risk of serious side effects. While tranexamic acid has relatively few known drug interactions compared to many other medications, the interactions that do exist can be clinically significant and potentially dangerous. It is crucial to inform your doctor or pharmacist about all medications, supplements, and herbal products you are taking or have recently taken.
Major Interactions
The following interactions are considered clinically significant and may require dose adjustment, alternative treatment, or enhanced monitoring:
| Interacting Drug | Interaction Effect | Risk Level | Recommendation |
|---|---|---|---|
| Anticoagulants (warfarin, heparin, enoxaparin) | Unpredictable effect on coagulation; may counteract anticoagulant effect or paradoxically increase clot risk | High | Only under specialist supervision with coagulation expertise |
| Thrombolytic agents (alteplase, streptokinase, tenecteplase) | Direct pharmacological antagonism; tranexamic acid inhibits fibrinolysis while thrombolytics activate it | High | Contraindicated – do not use concurrently |
| Factor IX complex concentrates | Increased risk of thrombosis due to combined prothrombotic effects | High | Avoid concurrent use |
| Anti-inhibitor coagulant concentrates (FEIBA) | Significantly increased risk of thromboembolic events | High | Avoid concurrent use |
Moderate Interactions
The following interactions warrant monitoring and discussion with your healthcare provider:
| Interacting Drug | Interaction Effect | Recommendation |
|---|---|---|
| Combined hormonal contraceptives (estrogen/progestogen pills, patches, rings) | Both increase thrombotic risk; combined use may have additive prothrombotic effect | Use with caution; discuss individual risk factors with your doctor |
| Tretinoin (all-trans retinoic acid) | Both agents may increase thrombotic risk; tretinoin activates coagulation cascade | Monitor for signs and symptoms of thrombosis |
| Direct oral anticoagulants (DOACs) (apixaban, rivaroxaban, dabigatran) | Similar concerns as with traditional anticoagulants; limited clinical data available | Use under specialist guidance only |
Always provide your healthcare provider with a complete list of all prescription drugs, over-the-counter medications, vitamins, and herbal supplements you are taking. This includes medications you may be using intermittently or topically. Some interactions may not be immediately apparent and require careful clinical assessment.
What Is the Correct Dosage of Cyklonova?
The recommended adult dose of Cyklonova for heavy menstrual bleeding is 2–3 tablets (1000–1500 mg) taken 3–4 times daily for 3–4 days. Treatment should begin when menstruation starts. For very heavy bleeding, the dose may be increased to 2 tablets 6 times daily. Always follow your doctor's instructions.
Always take Cyklonova exactly as your doctor or pharmacist has told you. Do not exceed the prescribed dose without medical advice. The dosage recommendations below are general guidelines; your doctor may adjust the dose based on your individual clinical situation, including body weight, severity of bleeding, and kidney function.
Adults
Standard Dosage for Heavy Menstrual Bleeding
- Dose: 2–3 tablets (1000–1500 mg) per dose
- Frequency: 3–4 times daily
- Duration: 3–4 days per menstrual cycle
- Maximum dose (very heavy bleeding): 2 tablets (1000 mg) up to 6 times daily
- Maximum daily dose: 6000 mg (12 tablets)
- When to start: At the onset of menstrual bleeding
The tablets may be split in half along the score line if a lower dose is required. Take the tablets with a glass of water. Cyklonova can be taken with or without food, although taking it with food may reduce gastrointestinal side effects such as nausea.
Children and Adolescents
Clinical experience with Cyklonova for the treatment of heavy menstrual bleeding in children and adolescents under 15 years of age is limited. If you are under 15, you should consult your doctor before starting treatment. Your doctor will determine whether Cyklonova is appropriate and will prescribe an individualized dose based on your weight and clinical situation.
Elderly Patients
No specific dose adjustments are generally required for elderly patients, provided kidney function is adequate. However, since renal function tends to decline with age, your doctor may check your kidney function before prescribing Cyklonova and may adjust the dose accordingly. Elderly patients may also be at increased risk of thromboembolic events, which should be considered when weighing the benefits and risks of treatment.
Patients with Kidney Impairment
Since tranexamic acid is primarily eliminated by the kidneys, dose reduction is necessary in patients with reduced kidney function. Your doctor will determine the appropriate dose based on your creatinine clearance or estimated glomerular filtration rate (eGFR). In patients with severe renal impairment, Cyklonova is contraindicated due to the risk of drug accumulation.
Missed Dose
If you forget to take a dose, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a forgotten dose.
Overdose
If you have taken more Cyklonova than prescribed, or if a child has accidentally ingested the medicine, contact your local poison control center or emergency department immediately for risk assessment and advice.
Symptoms of overdose may include:
- Nausea and vomiting
- Diarrhea
- Dizziness and headache
- Light-headedness and orthostatic hypotension (low blood pressure on standing)
- Muscle weakness
- Seizures (convulsions)
There is an increased risk of thrombosis (blood clot formation) in cases of overdose, particularly in individuals with predisposing risk factors for thromboembolic events.
Contact your local poison control center or emergency department immediately if you suspect an overdose. Do not wait for symptoms to develop. Provide information about the amount taken and the time of ingestion.
What Are the Side Effects of Cyklonova?
The most common side effects of Cyklonova include nausea, vomiting, diarrhea, abdominal pain, headache, and dizziness. These are usually mild and temporary. Rare but serious side effects include blood clots (thromboembolism) and seizures, which require immediate medical attention.
Like all medicines, Cyklonova can cause side effects, although not everyone experiences them. Most side effects are mild and resolve on their own without intervention. However, some side effects are serious and require immediate medical attention. Understanding the frequency and nature of potential side effects helps you make informed decisions and recognize when to seek medical care.
Common Side Effects
May affect up to 1 in 10 people
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain
- Headache
- Dizziness
Uncommon Side Effects
May affect up to 1 in 100 people
- Allergic skin reactions (rash, itching, urticaria)
Rare Side Effects
May affect up to 1 in 1,000 people
- Thromboembolic events (deep vein thrombosis, pulmonary embolism)
- Visual disturbances including changes in color vision
- Chest pain radiating to arms or neck
- Severe abdominal pain
- Paralysis or sensory disturbances
- Speech difficulties
- Painful, swollen arms or legs
- Shortness of breath
Frequency Not Known
Cannot be estimated from the available data
- Seizures (convulsions)
Stop taking Cyklonova and contact your doctor or emergency services immediately if you experience any of the following:
- Sudden shortness of breath or chest pain, which may indicate a pulmonary embolism
- Chest pain radiating to your arms or neck, which may indicate a cardiac event
- Severe abdominal pain, which may indicate mesenteric thrombosis
- Sudden weakness, numbness, or difficulty speaking, which may indicate a stroke
- A painful, swollen leg, which may indicate deep vein thrombosis
- Seizures or convulsions
Gastrointestinal side effects (nausea, vomiting, diarrhea) are the most frequently reported adverse reactions and are typically dose-dependent. They are usually mild and transient, resolving either spontaneously or after dose reduction. Taking Cyklonova with food may help reduce these symptoms.
Visual disturbances, including changes in color perception, have been reported in rare cases. If you experience any changes in your vision while taking tranexamic acid, discontinue the medication and consult an ophthalmologist. Long-term use has been associated with retinal changes in some animal studies, although the clinical significance of these findings is uncertain.
Reporting Side Effects
Reporting suspected adverse reactions after the medicine has been authorized is important. It allows continuous monitoring of the benefit/risk balance of the medicine. Healthcare professionals and patients are encouraged to report suspected adverse reactions to their national pharmacovigilance authority.
How Should You Store Cyklonova?
Store Cyklonova at room temperature below 30°C (86°F) in the original packaging. Keep out of sight and reach of children. Do not use after the expiry date printed on the packaging.
Proper storage of medications ensures they remain effective and safe throughout their shelf life. Follow these guidelines for storing Cyklonova:
- Temperature: Store at or below 30°C (86°F). Do not freeze.
- Light: Keep in the original blister packaging to protect from light and moisture.
- Children: Store out of sight and reach of children. Consider using a locked medicine cabinet.
- Expiry date: Do not use this medicine after the expiry date (EXP) printed on the packaging. The expiry date refers to the last day of that month.
- Disposal: Do not dispose of medicines in wastewater or household waste. Return unused or expired medicines to your pharmacy for proper disposal. This helps protect the environment.
If the tablets appear discolored, crumbled, or otherwise different from their normal appearance (white, capsule-shaped, film-coated, 18 mm long with a score line), do not take them and consult your pharmacist.
What Does Cyklonova Contain?
Each Cyklonova tablet contains 500 mg of the active substance tranexamic acid. Inactive ingredients include microcrystalline cellulose, povidone, croscarmellose sodium, colloidal anhydrous silica, talc, and magnesium stearate, with a film coating containing methacrylic acid copolymer, titanium dioxide (E171), talc, magnesium stearate, macrogol, and vanillin.
Active Ingredient
The active substance is tranexamic acid 500 mg per tablet. Tranexamic acid is a synthetic lysine analogue with a molecular weight of 157.21 g/mol. It acts as a competitive inhibitor of plasminogen activation, providing its antifibrinolytic effect.
Inactive Ingredients (Excipients)
The following inactive ingredients are present in the tablet core:
- Microcrystalline cellulose: Binder and filler that gives the tablet its structural integrity
- Povidone: Binding agent that helps the tablet ingredients stick together
- Croscarmellose sodium: Disintegrant that helps the tablet break apart in the digestive tract for absorption
- Colloidal anhydrous silica: Glidant that improves powder flow during manufacturing
- Talc: Lubricant and anti-adherent
- Magnesium stearate: Lubricant that prevents the tablet from sticking to manufacturing equipment
Film Coating
The film coating contains:
- Methacrylic acid copolymer (Eudragit E 100)
- Titanium dioxide (E171) – provides the white color
- Talc
- Magnesium stearate
- Macrogol
- Vanillin
Appearance and Pack Sizes
Cyklonova tablets are white, capsule-shaped, film-coated tablets with a score line, measuring 18 mm in length. The score line allows the tablet to be divided into two equal halves for dose flexibility.
Available pack sizes in blister packaging: 18, 20, 30, 50, 60, or 100 tablets. Not all pack sizes may be marketed in all countries.
Frequently Asked Questions About Cyklonova
Cyklonova contains tranexamic acid and is primarily used to treat heavy menstrual bleeding (menorrhagia). It works by preventing the breakdown of blood clots, thereby reducing blood loss during menstruation. Tranexamic acid is also used in other formulations for managing bleeding in surgery, trauma, and other medical conditions, though Cyklonova tablets are specifically indicated for menorrhagia.
The recommended dose is 2–3 tablets (1000–1500 mg) taken 3–4 times daily for 3–4 days. Treatment should begin when menstrual bleeding starts. For very heavy bleeding, the dose may be increased to up to 2 tablets 6 times daily, as directed by your doctor. The tablets can be split in half if needed. Take with water, and consider taking with food to reduce stomach-related side effects.
The most common side effects are gastrointestinal symptoms including nausea, vomiting, diarrhea, and abdominal pain, as well as headache and dizziness. These side effects are usually mild and temporary, often resolving on their own or with dose adjustment. Taking the medication with food may help reduce stomach-related symptoms. Rare but serious side effects include blood clots and seizures, which require immediate medical attention.
Concurrent use of Cyklonova with anticoagulants such as warfarin, heparin, or direct oral anticoagulants (DOACs) should only be done under the supervision of a specialist physician with expertise in coagulation disorders. The combination carries significant risks and requires careful monitoring. Never start or stop Cyklonova without informing all healthcare providers involved in your care.
Cyklonova is specifically indicated for heavy menstrual bleeding and is not intended for use during pregnancy or breastfeeding. Tranexamic acid crosses the placenta and is excreted in breast milk. While animal studies have not shown harmful effects, adequate controlled clinical trials in pregnant women are lacking. If you are pregnant, breastfeeding, or planning to become pregnant, consult your healthcare provider before using any tranexamic acid product.
Clinical studies, including Cochrane systematic reviews, have demonstrated that tranexamic acid reduces menstrual blood loss by approximately 40–50% compared to placebo. It is considered one of the most effective non-hormonal treatments for heavy menstrual bleeding and is recommended as a first-line option by NICE and other international guidelines. If Cyklonova does not provide sufficient relief, your doctor may recommend alternative or additional treatments, including hormonal options or surgical procedures.
References
This article is based on the following peer-reviewed sources, international guidelines, and regulatory documents:
- Bryant-Smith AC, Lethaby A, Farquhar C, Hickey M. Antifibrinolytics for heavy menstrual bleeding. Cochrane Database of Systematic Reviews. 2018;4(4):CD000249. doi:10.1002/14651858.CD000249.pub2
- CRASH-2 trial collaborators. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. The Lancet. 2010;376(9734):23–32.
- European Medicines Agency (EMA). Tranexamic acid – Summary of Product Characteristics. EMA/CHMP. Accessed January 2026.
- National Institute for Health and Care Excellence (NICE). Heavy menstrual bleeding: assessment and management. NICE guideline [NG88]. Updated 2021.
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List. Geneva: WHO; 2023.
- British National Formulary (BNF). Tranexamic acid. NICE/BNF. Accessed January 2026.
- Shakur H, Roberts I, Fawole B, et al. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. The Lancet. 2017;389(10084):2105–2116.
- International Federation of Gynecology and Obstetrics (FIGO). FIGO classification system for causes of abnormal uterine bleeding. Int J Gynaecol Obstet. 2011;113(1):3–13.
- Lukes AS, Moore KA, Muse KN, et al. Tranexamic acid treatment for heavy menstrual bleeding: a randomized controlled trial. Obstet Gynecol. 2010;116(4):865–875.
- Roberts I, Shakur-Still H, Afolabi A, et al. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT). The Lancet. 2020;395(10241):1927–1936.
About the Medical Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, comprising licensed specialist physicians with expertise in pharmacology, hematology, and gynecology. Our editorial process follows the GRADE evidence framework and adheres to international medical standards set by the WHO, EMA, and FDA.
Medical Review Board
Independent panel of medical experts who review all drug information content according to international pharmacological guidelines. All reviewers are board-certified physicians with clinical expertise in relevant specialties.
Evidence Standards
All medical claims in this article are supported by Level 1A evidence (systematic reviews and meta-analyses of randomized controlled trials) or official regulatory documents from the EMA, FDA, or WHO. No commercial funding or pharmaceutical industry sponsorship.