TXA in Anticoagulated Patients Study

Inclusion Criteria * Patients older than 18 years old * Patients undergoing scheduled primary anatomic total shoulder arthroplasty * Patients undergoing scheduled primary reverse total shoulder arthroplasty * Patients who consent to be randomized * Preoperative use of anticoagulant or antiplatelet therapy within 10 days prior to surgery: * Coumadin (Warfarin) * Heparin * Low molecular weight heparin * Factor Xa inhibitors * Apixaban (Eliquis) * Rivarixaban (Xatelto) * Edoxaban (Savaysa) * Dabigatran (Pradaxa) * Clopidogrel (Plavix) * Prasugrel (Effient) * Ticagrelor (Brilinta) Exclusion Criteria * Patients younger than 18 * Patients who are pregnant\* or breast-feeding women * Patients who are allergic to tranexamic acid * Patients scheduled for revision total shoulder arthroplasty * Patients with proximal humerus fracture or fracture sequelae * Patients who use estrogen containing medications (i.e. oral contraceptive pills) * Patients who have acquired disturbances of color vision * Patients with a history of any of the following diagnosis: ' * Subarachnoid hemorrhage * Active intravascular clotting * Severe pulmonary disease (FEV \<50% normal) * Plasma creatinine \> 115 μmol/L in males, \> 100 μmol/L in females, or hepatic failure) * (Renal impairment serum creatinine \> 1.5 times the upper limit of normal NYU) * Preoperative anemia \[Hemoglobin (Hb) \< 11g/dL in females, Hb \< 12 g/dL in males\] * Patients who refuse blood products * Patients undergoing hormone replacement therapy * Patients with diagnosed or self-reported cognitive dysfunction; * Patients who are unable to understand or follow instructions; * Patients with severe liver disease, renal insufficiency, congestive heart failure, and/or significant heart disease; * Patients with BMI over 50 * Any patient that the investigators feel cannot comply with all study related procedures.