One hundred seventy-five patients undergoing revision total hip arthroplasty were randomized to receive one of four tranexamic acid (TXA) regimens: a single 1-g intravenous (IV) dose (n=43), a double 1-g IV dose (n=40), a combined 1-g IV and 1-g topical dose (n=46), or three oral doses totaling 1,950 mg (n=46). The primary outcome was the reduction in postoperative hemoglobin levels. Secondary outcomes included calculated blood loss, transfusion rates, and venous thromboembolism incidence. Outcomes were assessed during hospitalization. Overall, the results demonstrated no significant differences among the four regimens in hemoglobin reduction, calculated blood loss, or transfusion rates. A single venous thromboembolism event was recorded, with no differences between groups. These findings suggest that all four TXA regimens are equally effective in minimizing perioperative blood loss in revision total hip arthroplasty, allowing surgeons to choose the most practical regimen for their practice.