Tranexamic acid is frequently used in surgeries with high risk of blood loss such as cardiac, liver, vascular and large orthopedic procedures. Its oral form is now being evaluated for use in outpatient conditions involving heavy bleeding.
Trauma
Tranexamic acid has been found to decrease the risk of death in people who have significant bleeding due to trauma. However, it may actually increase the risk of death due to bleeding if administered more than 3 hours after the injury. 
Heart surgery
Tranexamic acid is commonly used in cardiac surgery, both with and without cardiopulmonary bypass. It replaces aprotinin.
Orthopedic surgery
Tranexamic acid is used in orthopedic surgery to reduce bloodloss. It is of proven value in clearing the field of surgery and reducing pre- and postoperative blood loss. Drain and number of transfusions are reduced.
Menstrual bleeding
Used as firstline nonhormonal treatment of dysfunctional uterine bleeding, and heavy bleeding associated with uterine fibroids. A recent study showed patients treated with tranexamic acid are more likely to develop thrombosis and necrosis in their fibroids, and may result in pain and fever. 
Dentistry
Tranexamic acid is used in dentistry in the form of a 5% mouth rinse after extractions or surgery in patients with prolonged bleeding time, e.g. from acquired or inherited disorders.
Other usesIn obstetrics, tranexamic acid is used after delivery to reduce bleeding, often with syntocinon/oxytocin and fundal massage.
In hemophilia
Tranexamic acid is also useful in the treatment of bleeding as a second line treatment after factor VIII in patients (e.g. tooth extraction)
Whitening effect
Clinical studies for years have proved that tranexamic acid can dilute spot effectively and rapidly, which helps to demonstrate a perfect white and bright skin. The spot-removing effect of tranexamic acid is about 50 times over Vitamin C, and 10 times over AHA. The concentration limit of usage is 2%-3%, and in cosmetics the amount is around 0.5%.