Oral tranexamic acid is an off-label use oral medication for the treatment of melasma not responding to topical lightening agents. Its use for melasma treatment has been largely confined to Asia. The usual dose is 250mg (half a 500mg tablet) twice daily for 12 weeks. Higher doses may or may not confer greater lightening benefits.
The safety of the medication beyond 12 weeks of usage has not been determined. A detailed assessment by your doctor will be required before considering the use of oral tranexamic acid to treat recalcitrant melasma. Patients who are taking oral contraceptive pills, who smoke, have hypertension, diabetes, high lipid levels and who have a past history of clotting problem (e.g. deep vein thrombosis) should avoid taking this drug.
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