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Updated: Sep 19, 2025
Measuring Local Anaphylaxis in Mice
Published on: October 14, 2014
Tranexamic acid-induced anaphylaxis: a systematic review
Pei-Shuang Lin1,2, Yun-Tai Yao3,4,5,6, Alparslan Turan7,8
1Department of Cardiovascular Surgery, Fujian Medical University Affiliated First Quanzhou Hospital, Fujian, 362000, China.
Purpose:
Tranexamic acid (TXA) is a synthetic antifibrinolytic agent widely used in a diverse range of hemorrhagic scenarios. Despite documented superior safety profile, increasing reports have emerged describing anaphylactic reactions to TXA. We reviewed reported cases of anaphylactic reactions to TXA and summarize their clinical characteristics, diagnosis and treatment protocols.
Methods:
PubMed, Embase, Web of Science were searched with the terms "tranexamic acid", "antifibrinoly*", "anaphylaxis", "anaphylactic", "anaphylactoid", "allergy" and "hypersensitivity" to identify relevant case reports. Data were extracted and analyzed.
Results:
Our review identified 15 cases of TXA-induced anaphylaxis. Patients were 2 to 80 years old, with 60.0% adults. The most common symptoms were hypotension, hypoxia and rash in an equal 66.7%, followed by tachycardia in 60.0%. TXA was confirmed as the culprit allergen in 73.3% of cases through allergological workup. Major treatments consisted of corticosteroids (80.0%), epinephrine (73.3%) and antihistamine (60.0%). While most patients recovered, 1 patient experienced recurrent anaphylaxis and 1 patient died.
Conclusions:
Anaphylaxis to TXA is a rare drug adverse reaction with varying manifestations. Prompt recognition and appropriate treatment are critical in facilitating optimal outcomes.
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