Although not FDA approved (except for metrorrhagia) in the US; there is increasing evidence of its topical use as an adjunct for anterior packing or even as only.
One way to use TXA in anterior epistaxis, is to do you regular packing (RhinoRocket, Merocell or vaseline gauze) and then spray and soak the packing with TXA. I’ve being doing it for a few months and works fine.
Also, you can spray directly into the nostrils and achieve primary hemostasis.
Zahed, R., Moharamzadeh, P., AlizadehArasi, S., Ghasemi, A., & Saeedi, M. (2013). A new and rapid method for epistaxis treatment using injectable form of tranexamic acid topically: a randomized controlled trial. The American Journal of Emergency Medicine. doi:10.1016/j.ajem.2013.06.043