Tranexamic Acid and Estradiol Topical: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Estradiol Topical
Tranexamic Acid
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of thrombotic events
Interaction Deep Dive
Concomitant use of hormonal contraceptives and tranexamic acid is contraindicated due to further increased risk of thrombotic events, especially in women who are obese, or smoke cigarettes, and more so, in smokers over the age of 35 years1. Concomitant use of tranexamic acid and all hormonal contraceptives should be avoided, and an effective alternative nonhormonal contraceptive method should be used 2. Venous and arterial thrombotic events have been reported during postmarketing surveillance of women concomitantly treated with combined hormonal contraceptives and tranexamic acid 1.
Why it happens (mechanism)
Unknown
Common questions
Can I take Tranexamic Acid and Estradiol Topical together?
An increased risk of thrombotic events Always confirm with your pharmacist or prescriber before making any change.
How serious is the Tranexamic Acid and Estradiol Topical interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Tranexamic Acid or Estradiol Topical need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: LYSTEDA(TM) oral tablets, tranexamic acid oral tablets. Ferring Pharmaceuticals Inc. (per FDA), Parsippany, NJ, 2013. DailyMed
- Product Information: CYKLOKAPRON(R) intravenous injection, tranexamic acid intravenous injection. Pharmacia & Upjohn Company (per FDA), New York, NY, 2020. DailyMed
Keep reading about Estradiol Topical
Keep reading about Tranexamic Acid
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