Multiple Dose vs. Single Dose
Administration of multiple doses of IV or oral TXA compared to a single dose of IV or oral TXA does not significantly alter the amount of calculated blood loss and need for transfusion during the perioperative episode of a primary TJA.
Tranexamic Acid in Total Joint Arthroplasty
Developed by the American Association of Hip and Knee Surgeons

Rationale
Direct meta-analysis was performed using six high quality studies to compare between a single dose and multiple doses of IV TXA during primary TKA, which demonstrated no additional benefit for multiple doses of IV TXA.3 Due to a limited number of studies, direct meta-analysis could not be performed for primary THA. However, the results of the available individual studies consistently demonstrate no additional benefit for multiple doses of IV TXA in primary THA.8,10,11

An expanded comparison was performed through a network meta-analysis on primary hip and knee arthroplasties. Multiple doses of oral TXA have not been studied in primary THA, thus analysis was only available for IV TXA in primary THA. Network meta-analysis showed no additional benefit in terms of blood loss or risk of transfusion for multiple doses of IV TXA compared with a single dose.5 Similarly, the results for primary TKA supported no benefit for multiple doses of IV or oral TXA compared to a single dose of either IV or oral TXA.3

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