Systematic Review of Tranexamic Acid Adverse Reactions

Gioacchino Calapai, Sebastiano Gangemi, Carmen Mannucci, Paola Lucia Minciullo, Marco Casciaro, Fabrizio Calapai, Maria Righi and Michele Navarra

Background : Tranexamic acid is a synthetic lysine derivate that exerts its antifibrinolytic effect by reversible blocking lysine binding sites on plasminogen preventing fibrin degradation. It is widely used for haemorrhage or risk of haemorrhage in increased fibrinolysis or fibrinogenolysis.

Aim: The aim of our work was to review the literature regarding the best evidence on tranexamic adverse reactions and to describe them according to the apparatus involved.

Methods: The literature was searched for publications on tranexamic acid adverse reactions, adverse events, using MEDLINE, Scopus, Embase, Web of Science and Google Scholar.

Results: In the light of the results, seems to be clear that tranexamic acid causes several adverse reactions involving different apparatus. Hypersensitivity reactions, cerebrovascular infarction, myocardial infarction and pulmonary embolism seem to be the more common tranexamic acid adverse reactions.

Conclusion: Despite the wide use of tranexamic acid the number of cases reported for type of reaction is relatively low, thus causing a not easy understanding of mechanisms underlying the adverse reaction. Therefore, it would be appropriate to conduct epidemiological studies on a large scale in order to better understand risk factors favoring tranexamic acid adverse reactions and encourage pharmacovigilance in medical practice.