Hypersensitivity to tranexamic acid: a wide spectrum of adverse reactions

Imbesi, S.; Nettis, Eustachio; Minciullo, Paola Lucia; Leo, Elisabetta; Saija, Antonella; Vacca, Angelo; Gangemi, Sebastiano

doi:10.1007/s11096-010-9415-8

Cited by 55 publications

(28 citation statements)

References 11 publications

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“…So far, the allergic reactions reported for the oral form were milder and slower onset29,30). The oral form in this context seems to be a better choice than the intravenous form, provided drug efficacies are similar.…”

Section: Discussionmentioning

confidence: 98%

Blood Sparing Efficacy of Oral Tranexamic Acid in Primary Total Knee Arthroplasty: A Randomized Controlled Trial

Lee¹,

Ching²,

Wong³

2017

Knee Surg Relat Res

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PurposeTranexamic acid (TXA) is effective in reducing blood loss in primary total knee replacement. Almost all studies used an intravenous form or a topical form. The aim of this study was to assess the blood sparing efficacy and the safety of oral TXA.Materials and MethodsAll patients with primary total knee replacement performed in our institute from January 2015 to October 2015 were eligible. Oral TXA group was given 1 g oral TXA 2 hours before induction of anesthesia and 6 hours and 12 hours postoperatively. The control group was not given TXA.ResultsThere were 94 cases in the oral TXA group and 95 cases in the control group. There was no difference in the baseline characteristics. The oral TXA group had a significantly lower hemoglobin drop (1.7 g/dL vs. 2.5 g/dL), lower drain output (154 mL vs. 203 mL), lower hidden blood loss (244 mL vs. 423 mL) and lower total blood loss (398 mL vs. 626 mL). There was no difference in transfusion rate (1.1% vs. 3.2%) and thromboembolic complication. There was no infection or mortality in both groups.ConclusionsOral TXA is effective in reducing blood loss in primary total knee replacement. It is a safe alternative to the intravenous or topical form.

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Section: Discussionmentioning

confidence: 98%

Blood Sparing Efficacy of Oral Tranexamic Acid in Primary Total Knee Arthroplasty: A Randomized Controlled Trial

Lee¹,

Ching²,

Wong³

2017

Knee Surg Relat Res

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“…In the 5 cases reported by Imbesi et al [5], many had systemic reactions following the parenteral or oral administration of TXA, but skin testing and blood tests to confirm allergic reactivity were not performed in 4 of the cases. In the fifth case skin prick and intradermal testing was performed with neat TXA.…”

Section: Discussionmentioning

confidence: 99%

Tranexamic Acid: An Exceedingly Rare Cause of Anaphylaxis during Anaesthesia

Bansal

Nicholas

Bansal

2016

Case Reports in Immunology

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Tranexamic acid (TXA) allergy is extremely rare. An 80-year-old woman without prior exposure to TXA underwent elective knee replacement. Shortly after induction of anaesthesia and intravenous TXA, she developed hypotension, tachycardia, and facial erythema accompanied by a raised serum tryptase. Later, skin prick and intradermal testing confirmed positive responses to TXA in high dilution and with negative results to the other drugs used. While neuromuscular blocking agents, opiates, and antibiotics remain the most frequent cause of anaphylaxis during anaesthesia, allergy to TXA should always be borne in mind and requires skin testing for confirmation as there are presently no blood tests available.

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“…The processed PCC appears to be less likely than plasma to generate reactions; however, it is important to note that PCC preparations may contain heparin, and thus place patients at risk for the development of Heparin-Induced Thrombocytopenia (HIT) (80). Both minor and severe tranexamic acid (TXA) reactions have also been reported; however, these appear to be rare (81). …”

Section: Conmentioning

confidence: 99%

Is Coagulopathy an Appropriate Therapeutic Target During Critical Illness Such as Trauma or Sepsis?

Moore

Winfield

Aibiki

et al. 2017

Shock

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Coagulopathy is a common and vexing clinical problem in critically ill patients. Recently, major advances focused on the treatment of coagulopathy in trauma and sepsis have emerged. However, the targeting of coagulopathy with blood product transfusion and drugs directed at attenuating the physiologic response to these conditions have major potential risk to the patient. Therefore, the identification of coagulopathy as a clinical target is an area of uncertainty and controversy. In order to analyze the state of the science regarding coagulopathy in critical illness, a symposium addressing the problem was organized at the 39th annual meeting of the Shock Society in the summer of 2016. This manuscript synthesizes the viewpoints of the four expert panelists at the debate and presents an overview of the potential positive and negative consequences of targeting coagulopathy in trauma and sepsis.

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Hypersensitivity to tranexamic acid: a wide spectrum of adverse reactions

Cited by 55 publications

References 11 publications

Blood Sparing Efficacy of Oral Tranexamic Acid in Primary Total Knee Arthroplasty: A Randomized Controlled Trial

Blood Sparing Efficacy of Oral Tranexamic Acid in Primary Total Knee Arthroplasty: A Randomized Controlled Trial

Tranexamic Acid: An Exceedingly Rare Cause of Anaphylaxis during Anaesthesia

Is Coagulopathy an Appropriate Therapeutic Target During Critical Illness Such as Trauma or Sepsis?

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