Topical use of tranexamic acid: Are there concerns for cytotoxicity?

Table 2 Characteristics and outcomes of studies that proved cytotoxic effects of tranexamic acid

Ref.	Tissue	Doses	Time of exposure	Outcome
Tuttle et al[22], 2015	Animal samples (bovine and murine)	25, 50, and 100 mg/mL in murine chondrocytes and 100 mg/mL in bovine chondrocytes	8, 24, and 48 h for both bovine and murine explants	Cell viability was notably decreased as TXA dose and incubation time were increased
Parker et al[28], 2018	Human samples (chondrocytes on 2D and 3D models)	5, 10, 20, and 40 mg/mL in 2D cultures and 10, 20, and 40 mg/mL in 3D cultures	3, 6 and 12 h for the 2D models and 3 h for the 3D models	Cell viability, cellular metabolic activity, and number of attached cells were considerably decreased in a dose-dependent way
Goderecci et al[26], 2019	Human samples (chondrocytes)	20, 50, 70, and 100 mg/mL	10 min, 24 h, and 48 h	Chondrocyte viability and cell cycle profile were affected in a dose- and time-dependent way
McLean et al[27], 2019	Human samples (tendon, synovial, and cartilage tissues)	0, 1, 50, and 100 mg/mL	1, 4, and 24 h	Cell viability and apoptosis rate were affected at higher doses

TXA: Tranexamic acid.