What is the use of pause injection?: A Comprehensive Guide to Tranexamic Acid

October 6, 2025 •

4 min read

Abnormal uterine bleeding accounts for one-third of all gynecologic evaluations [1.3.1]. For this and other conditions involving excessive bleeding, the question of what is the use of pause injection becomes critical. This medication plays a vital role in preventing severe blood loss [1.2.3].

Quick Summary

Pause injection, with the active ingredient tranexamic acid, is an antifibrinolytic drug that controls excessive bleeding [1.2.1, 1.2.3]. It works by preventing the breakdown of blood clots, making it vital in surgery, trauma, and for heavy periods [1.2.3, 1.3.2].

Key Points

Primary Active Ingredient: Pause injection contains Tranexamic Acid, which is an antifibrinolytic agent used to control bleeding [1.2.1].
Mechanism of Action: It works by preventing the enzymatic breakdown of blood clots, leading to hemostasis (stoppage of bleeding) [1.2.3, 1.3.2].
Major Clinical Uses: It is widely used for heavy menstrual bleeding, reducing blood loss during surgery (cardiac, orthopedic), and managing hemorrhage in trauma [1.2.1, 1.3.1].
Method of Administration: Pause injection is administered intravenously in a clinical setting by a healthcare professional and should not be self-injected [1.2.2, 1.2.3].
Most Significant Risk: The primary risk is an increased chance of blood clots (thromboembolism), such as deep vein thrombosis or pulmonary embolism [1.2.3, 1.5.4].
Important Contraindications: It should not be used by individuals with a history of blood clots or those taking combined hormonal contraceptives [1.5.5].
Not a Painkiller: Pause injection is specifically for controlling bleeding and does not relieve menstrual pain or cramps directly [1.2.2].

Understanding Pause Injection and Its Active Ingredient

Pause injection is a branded version of the medication Tranexamic Acid (TXA) [1.2.1]. It belongs to a class of drugs known as antifibrinolytics [1.2.3]. The primary function of an antifibrinolytic is to prevent the dissolution of fibrin, a key protein that forms the meshwork of a blood clot [1.3.2]. By stabilizing these clots, Pause injection helps to prevent or reduce the severity of bleeding episodes [1.2.3]. This medication is not a painkiller and does not stop menstrual cycles; its specific purpose is to manage blood loss [1.2.2]. It is typically administered intravenously by a healthcare professional in a hospital or clinical setting and should not be self-injected [1.2.2, 1.2.3].

The Science Behind a Stable Clot: Mechanism of Action

To understand how Pause injection works, it's essential to know about fibrinolysis, the body's natural process for breaking down blood clots. An enzyme called plasmin is responsible for dissolving clots by degrading fibrin [1.3.2]. Tranexamic acid, the active component in Pause injection, is a synthetic derivative of the amino acid lysine [1.3.1]. It functions by competitively blocking the lysine binding sites on plasminogen, the precursor to plasmin [1.3.1, 1.3.4]. This action prevents plasminogen from converting into plasmin and binding to fibrin, thus inhibiting the breakdown of the clot [1.3.2, 1.3.3]. The result is a more stable clot that can effectively stop bleeding [1.3.1]. Tranexamic acid is approximately eight to ten times more potent than its older counterpart, aminocaproic acid [1.3.4, 1.7.2].

Primary Clinical Applications of Pause Injection

Due to its effectiveness in promoting hemostasis (the stoppage of bleeding), Pause injection is utilized in a wide range of medical scenarios [1.2.5].

Heavy Menstrual Bleeding (Menorrhagia)

One of the most common and FDA-approved uses for tranexamic acid is the management of heavy menstrual bleeding [1.4.1]. Studies have shown that it can reduce menstrual blood loss by 34% to 54% [1.8.2, 1.8.4]. It is considered a first-line, non-hormonal treatment option for women who prefer to avoid hormonal contraceptives or for whom they are ineffective [1.4.3, 1.4.4].

Surgical Procedures

Pause injection significantly reduces blood loss during and after various surgeries, diminishing the need for blood transfusions [1.8.1]. It is frequently used in:

Cardiac Surgery: It lowers the risk of bleeding without increasing the risk of thrombotic complications or death [1.3.1, 1.8.5].
Orthopedic Surgery: In procedures like total knee and hip replacements, TXA has been shown to reduce blood loss and transfusion requirements [1.3.1, 1.7.3].
Myomectomy: For patients undergoing surgery to remove uterine fibroids, TXA can significantly reduce intraoperative and total blood loss [1.8.3].
Dental Extractions: Especially in patients with bleeding disorders like hemophilia, TXA is used to prevent and reduce hemorrhage following tooth removal [1.2.4, 1.6.4].

Trauma and Emergency Medicine

In cases of major trauma, tranexamic acid can be life-saving. Landmark studies like the CRASH-2 trial demonstrated that early administration (within three hours of injury) significantly reduces mortality due to bleeding [1.3.1]. It is now a standard component of trauma care for patients at risk of significant hemorrhage [1.3.1]. Similarly, it is a recommended treatment for postpartum hemorrhage (PPH), a leading cause of maternal mortality worldwide [1.3.2, 1.8.4].

Potential Side Effects and Important Precautions

While generally well-tolerated, Pause injection has potential side effects. Common ones are often mild and may include nausea, vomiting, diarrhea, back pain, and headache [1.2.3, 1.5.1].

The most significant risk associated with tranexamic acid is an increased chance of developing blood clots, a condition known as thromboembolism (e.g., deep vein thrombosis or pulmonary embolism) [1.2.3, 1.5.4]. For this reason, it is contraindicated in individuals with:

A personal history of blood clots or active thromboembolic disease [1.5.5].
An intrinsic risk for thrombosis [1.5.5].
Those using combined hormonal contraceptives, as this further increases clot risk [1.5.4].

Rare but serious side effects can include severe allergic reactions (anaphylaxis), seizures (particularly at high doses in cardiac surgery), and vision problems, such as changes in color vision [1.2.3, 1.5.4]. Any changes in vision should be reported to a doctor immediately, and regular eye check-ups may be necessary for long-term treatment [1.2.3, 1.9.2]. Dosage adjustments are also required for patients with kidney disease, as the drug is primarily eliminated by the kidneys [1.5.2, 1.6.1].

Comparison of Antifibrinolytic Agents

Tranexamic acid is not the only medication used to control bleeding. A comparison helps to understand its place in therapy.


Feature	Pause Injection (Tranexamic Acid)	Epsilon-Aminocaproic Acid (EACA)	Hormonal Contraceptives (for HMB)
Mechanism	Blocks plasminogen activation, preventing clot breakdown [1.3.1]	Also an antifibrinolytic, but less potent than TXA [1.7.1, 1.7.2]	Regulates the menstrual cycle and endometrial lining [1.2.2]
Primary Use	Broad: Heavy bleeding, surgery, trauma [1.2.1, 1.2.5]	Bleeding control, often in surgery [1.7.1]	Heavy menstrual bleeding (HMB), contraception [1.2.2]
Potency	Approximately 8-10 times more potent than EACA [1.3.4, 1.7.2]	Lower potency [1.7.1]	Varies by formulation
Administration	IV injection, oral tablets [1.4.5]	IV, oral [1.7.1]	Oral tablets, IUD, patch [1.2.2]

Conclusion

Pause injection, containing tranexamic acid, is a powerful and essential medication for managing a wide spectrum of bleeding conditions. By effectively stabilizing blood clots, it reduces blood loss in settings from elective surgery to life-threatening trauma and improves the quality of life for those with heavy menstrual bleeding [1.2.3, 1.4.3]. However, due to its mechanism of action, it carries a risk of thromboembolic events, making careful patient selection and professional medical supervision paramount [1.5.5]. Its use must always be guided by a healthcare professional who can weigh the benefits against the potential risks for each individual patient [1.2.3].

For more in-depth clinical information, consult resources like the National Center for Biotechnology Information (NCBI).

Frequently Asked Questions

Pause injection is primarily used to prevent and treat excessive bleeding. Its uses include managing heavy menstrual periods, reducing blood loss during and after surgery (like dental, prostate, or cardiac surgery), and controlling bleeding from nosebleeds or trauma [1.2.1, 1.2.3].

No, Pause injection is not a painkiller. Its active ingredient, tranexamic acid, is an antifibrinolytic that works to control bleeding. While it may reduce pain associated with heavy bleeding as the flow subsides, it does not have a direct pain-killing effect [1.2.2].

When administered intravenously, tranexamic acid begins to work quickly to help control bleeding [1.3.1]. The full effect can take up to 24 hours, but it is administered in urgent situations for its rapid onset [1.9.3].

Pause injection is not intended to stop your period entirely. It is used to reduce the amount of blood loss during a heavy menstrual cycle. It does not typically affect the regularity or duration of the menstrual cycle itself [1.2.2].

The most serious side effects are related to its blood-clotting mechanism, including deep vein thrombosis (DVT) and pulmonary embolism. Other rare but serious risks include severe allergic reactions (anaphylaxis), seizures, and vision changes. Immediate medical attention is required if these occur [1.2.3, 1.5.4].

You should not take Pause injection (tranexamic acid) if you are using birth control that contains both estrogen and a progestin (combined hormonal contraceptives). Taking both together significantly increases the risk of developing blood clots [1.5.4, 1.5.5].

Individuals with a history of blood clots (thromboembolism), active blood clotting problems, bleeding in the brain, or a known allergy to tranexamic acid should not use this medication [1.5.3, 1.5.6].