Tranexamic acid-induced anaphylaxis: a systematic review

Ng W, Jerath A, Wąsowicz M (2015) Tranexamic acid: a clinical review. Anaesthesiol Intensive Ther 47:339–350. https://doi.org/10.5603/AIT.a2015.0011

Article  PubMed  Google Scholar 

Hunt BJ (2015) The current place of tranexamic acid in the management of bleeding. Anaesthesia 70(Suppl 1):50–53, e18. https://doi.org/10.1111/anae.12910

Article  CAS  PubMed  Google Scholar 

Colomina MJ, Contreras L, Guilabert P et al (2022) Clinical use of tranexamic acid: evidences and controversies. Braz J Anesthesiol 72:795–812. https://doi.org/10.1016/j.bjane.2021.08.022

Article  PubMed  Google Scholar 

CRASH-2 Trial Collaborators; Shakur H, Roberts I, Bautista R et al (2010) Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet 376:23-32. https://doi.org/10.1016/S0140-6736(10)60835-5

WOMAN Trial Collaborators (2017) Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet 389:2105–2116. https://doi.org/10.1016/S0140-6736(17)30638-4

Article  Google Scholar 

World Health Organization (2011) The selection and use of essential medicines (2011)-TRS 965. https://iris.who.int/bitstream/handle/10665/44771/WHO_TRS_965_eng.pdf?sequence=1. Accessed July 15, 2024.

Gaćina K, KrstanovićĆosić A (2023) The use of tranexamic acid in dermatology. Acta Clin Croat 62:368–372. https://doi.org/10.20471/acc.2023.62.02.16

Article  PubMed  PubMed Central  Google Scholar 

YS Research (2024) 2024 Research report on market share and ranking of leading enterprises in the global and Chinese tranexamic acid active pharmaceutical ingredient industry. https://www.yhresearch.cn/reports/1535840/raw-material-of-tranexamic-acid. Accessed May 17, 2025.

Tian N, Sun Y, Liu Y et al (2024) Safety assessment of tranexamic acid: real-world adverse event analysis from the FAERS database. Front Pharmacol 15:1388138. https://doi.org/10.3389/fphar.2024.1388138

Article  CAS  PubMed  PubMed Central  Google Scholar 

Murao S, Nakata H, Roberts I et al (2021) Effect of tranexamic acid on thrombotic events and seizures in bleeding patients: a systematic review and meta-analysis. Crit Care 25:380. https://doi.org/10.1186/s13054-021-03799-9

Article  PubMed  PubMed Central  Google Scholar 

Patel PA, Wyrobek JA, Butwick AJ et al (2022) Update on applications and limitations of perioperative tranexamic acid. Anesth Analg 135:460–473. https://doi.org/10.1213/ANE.0000000000006039

Article  PubMed  Google Scholar 

Murdaca G, Greco M, Vassallo C et al (2020) Tranexamic acid adverse reactions: a brief summary for internists and emergency doctors. Clin Mol Allergy 18:16. https://doi.org/10.1186/s12948-020-00131-8

Article  CAS  PubMed  PubMed Central  Google Scholar 

Cardona V, Ansotegui IJ, Ebisawa M et al (2020) World allergy organization anaphylaxis guidance 2020. World Allergy Organ J 13:100472. https://doi.org/10.1016/j.waojou.2020.100472

Article  PubMed  PubMed Central  Google Scholar 

Lucas-Polomeni MM, Delaval Y, Menestret P et al (2004) Un cas de choc anaphylactique à l’acide tranexamique (Exacyl) [A case of anaphylactic shock with tranexamique acid (Exacyl)]. Ann Fr Anesth Reanim 23:607–609. https://doi.org/10.1016/j.annfar.2004.04.012

Article  PubMed  Google Scholar 

Ring J, Messmer K (1977) Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet 1:466–469. https://doi.org/10.1016/s0140-6736(77)91953-5

Article  CAS  PubMed  Google Scholar 

Manian DV, Volcheck GW (2022) Perioperative anaphylaxis: evaluation and management. Clin Rev Allergy Immunol 62:383–399. https://doi.org/10.1007/s12016-021-08874-1

Article  PubMed  Google Scholar 

Keskin DM, Kocaoğlu M, Yıldırım A et al (2025) First reported case of anaphylaxis to nebulized tranexamic acid in a pediatric patient: a rare but critical event. Pediatr Allergy Immunol Pulmonol 38:29–31. https://doi.org/10.1089/ped.2024.0035

Article  PubMed  Google Scholar 

Zibanejad N, Nouri N, Babaie S (2024) Anaphylactic reaction to tranexamic acid infusion in a six-year-old child: a case report. Int J Emerg Med 17:129. https://doi.org/10.1186/s12245-024-00718-x

Article  PubMed  PubMed Central  Google Scholar 

Sanchez Salcedo L, Manuel Baloira F, Adrover A et al (2023) Tranexamic acid in cardiac surgery: a case report of an infrequent adverse reaction to a common medication. A A Pract 17:e01730. https://doi.org/10.1213/XAA.0000000000001730

Article  PubMed  Google Scholar 

Henriksson M, Nordblad M, Dabrowska D et al (2023) The road to hell is paved with good intentions: a first case report of anaphylaxis to tranexamic acid in an obstetric patient. Int J Obstet Anesth 54:103743. https://doi.org/10.1016/j.ijoa.2023.103743

Article  Google Scholar 

Mir J, Shafer K (2021) Takotsubo cardiomyopathy: a rare reaction to tranexamic acid. Ches 160: 4 (A175) Supplement. https://doi.org/10.1016/j.chest.2021.07.194

El Hanache H, Verdaguer M, Collin L et al (2021) Two cases of anaphylaxis to tranexamic acid confirmed by drug provocation test: what about skin tests? J Investig Allergol Clin Immunol 31:351–353. https://doi.org/10.18176/jiaci.0651

Article  PubMed  Google Scholar 

Plaster S, Holy F, Antony AK (2020) Anaphylactic reaction to tranexamic acid during posterior spinal fusion: a case report. JBJS Case Connect 10(e20):00130. https://doi.org/10.2106/JBJS.CC.20.00130

Article  Google Scholar 

Clark N, Morris S, Sargant N (2018) Comment on Chiem J, Ivanova I, Jimenez N. Anaphylactic reaction to tranexamic acid in an adolescent undergoing posterior spinal fusion. Paediatr Anaesth 28:184–185. https://doi.org/10.1111/pan.13303

Article  PubMed  Google Scholar 

Li PH, Trigg C, Rutkowski R et al (2017) Anaphylaxis to tranexamic acid-a rare reaction to a common drug. J Allergy Clin Immunol Pract 5:839–841. https://doi.org/10.1016/j.jaip.2016.12.014

Article  PubMed  Google Scholar 

Chiem J, Ivanova I, Parker A et al (2017) Anaphylactic reaction to tranexamic acid in an adolescent undergoing posterior spinal fusion. Paediatr Anaesth 27:774–775. https://doi.org/10.1111/pan.13141

Article  PubMed  Google Scholar 

Bansal RA, Nicholas A, Bansal AS (2016) Tranexamic acid: an exceedingly rare cause of anaphylaxis during anaesthesia. Case Reports Immunol 2016:7828351. https://doi.org/10.1155/2016/7828351

Article  CAS  PubMed  PubMed Central  Google Scholar 

Samanta S, Samanta S, Jain K et al (2013) Global left and right ventricular dysfunction after tranexamic acid administration in a polytrauma patient. Ann Card Anaesth 16:305–307. https://doi.org/10.4103/0971-9784.119193

Article  PubMed  Google Scholar 

Imbesi S, Nettis E, Minciullo PL et al (2010) Hypersensitivity to tranexamic acid: a wide spectrum of adverse reactions. Pharm World Sci 32:416–419. https://doi.org/10.1007/s11096-010-9415-8

Article  CAS  PubMed  Google Scholar 

Regateiro FS, Marques ML, Gomes ER (2020) Drug-induced anaphylaxis: an update on epidemiology and risk factors. Int Arch Allergy Immunol 181:481–487. https://doi.org/10.1159/000507445

Article  CAS  PubMed  Google Scholar 

Kounis NG (2016) Kounis syndrome: an update on epidemiology, pathogenesis, diagnosis and therapeutic management. Clin Chem Lab Med 54:1545–1559. https://doi.org/10.1515/cclm-2016-0010

Article  CAS  PubMed  Google Scholar 

Singh T, Khan H, Gamble DT et al (2022) Takotsubo syndrome: pathophysiology, emerging concepts, and clinical implications. Circulation 145:1002–1019. https://doi.org/10.1161/CIRCULATIONAHA.121.055854

Article  CAS  PubMed  PubMed Central  Google Scholar 

Cha YS, Kim H, Bang MH et al (2016) Evaluation of myocardial injury through serum troponin I and echocardiography in anaphylaxis. Am J Emerg Med 34:140–144. https://doi.org/10.1016/j.ajem.2015.09.038

Article  PubMed 

Comments (0)

No login
gif