The studies cited above used a variety of methods for extemporaneous compounding of TXA ranging from % to 10% solutions. Two methods have been suggested depending on the formulation used. ( 21275495 ) If the 100 mg/mL or 10% solution for injection is used, a 5% oral solution can be prepared by diluting 5 mL of tranexamic acid with 5 mL of sterile water. If the 500 mg tablets are available, one tablet can be placed into 20 mL of water, and stirred until the tablets are completely disintegrated to form a fine particular suspension. It is suggested that a maximum expiration date of five days should be employed if refrigerated, and the solution should be protected from light. 3 In the place of a 500 mg tablet, it seems that use of a 650 mg tablet dissolved in 20 mL could be safely used as well. This is supported by evidence in which a 500 mg tablet was dissolved in 10 mL of water with no reports of adverse events. ( 24808695 ) There is evidence to support that an even lower concentration may be effective, as a % solution was utilized by Kaewpradub and colleagues, although higher concentrations have safely been used.
Topical analgesia is generally recommended to avoid systemic side-effects. Painful joints, for example, may be treated with an ibuprofen - or diclofenac -containing gel (The labeling for topical diclofenac has been updated to warn about drug-induced hepatotoxicity.  ); capsaicin also is used topically . Lidocaine , an anesthetic , and steroids may be injected into painful joints for longer-term pain relief. Lidocaine is also used for painful mouth sores and to numb areas for dental work and minor medical procedures. In February 2007 the FDA notified consumers and healthcare professionals of the potential hazards of topical anesthetics entering the blood stream when applied in large doses to the skin without medical supervision. These topical anesthetics contain anesthetic drugs such as lidocaine, tetracaine, benzocaine, and prilocaine in a cream, ointment, or gel.