Hypersensitivity to tranexamic acid: a wide spectrum of adverse reactions.

CASES DESCRIPTION: This is a retrospective study, based on analysis of data from patients with previous adverse drug reactions admitted to the Allergy and Clinical Immunology Division of both the University of Messina and the University of Bari in the last 4 years. We observed five patients: four of them (two males and two females) with a well documented history of tranexamic acid hypersensitivity reactions and one female who showed a positive response to an intradermal challenge test with tranexamic acid. CONCLUSIONS: Although the risk of immunogenic and severe allergic reactions to tranexamic acid is significantly lower than those associated with administration of other drugs, our experience points out that adverse reactions to tranexamic acid can occur. This drug may be responsible for a wide and various spectrum of hypersensitivity reactions characterized by different pathogenetic mechanisms (immunologic and non-immunologic). Etamsylate was a well tolerated alternative drug to tranexamic acid in all examined patients.