Inclusion Criteria:  Age 18-100 Male and Female Patient able to read and understand consent form Non-traumatic, simple small or medium sized rotator cuff tear as defined by pre-operative MRI Booked to operating room for elective rotator cuff repair Beach chair positioning  Exclusion Criteria:  Patient refusal to participate Massive rotator cuff tear Acute traumatic rotator cuff tear Known coagulopathy Patients with a history or risk of thromboembolism Known hypersensitivity to tranexamic acid Patient unable to be off anti-coagulant medication for long enough to counter effects Patient has a clinic systolic blood pressure > 150mmHg Lateral positioning Requirement or insistence by patient or anesthesiologist on regional block Patients who have smoked nicotine products within the last year The presence of other inflammatory conditions (calcific tendonitis, rheumatoid arthritis, etc.) The presence of active thromboembolic disease, such as deep vein thrombosis, pulmonary embolism, and cerebral thrombosis Patient has a seizure disorder Patients on medications identified as having drug-drug interactions (hormonal contraceptive, hydrochlorothiazide, desmopressin, sulbactam-ampicilllin, carbazochrome, ranitidine, or nitroglycerine Patient is pregnant Patients with history of subarachnoid hemorrhage Patients with renal insufficiency Patients with acquired disturbances of color vision