Inclusion Criteria:  Undergoing endoscopic pituitary surgery at UNC  Exclusion Criteria:  Clival invasion Giant pituitary tumor (>4 cm) Revision pituitary surgery Prior sinus surgery Lund McKay score > 3 Active thromboembolic disease Coagulopathy Concomitant pro-thrombotic medications Concomitant use of anti-coagulants or anti-platelet agents Subarachnoid hemorrhage History of severe hypersensitivity to Tranexamic Acid