Tranexamic Acid use in Trauma: Effective but not Without Consequences

Tranexamic Acid (TXA), a synthetic derivative of the amino acid lysine, was originally approved by the U.S. Food and Drug Administration in 1986 to reduce bleeding in hemophiliacs undergoing tooth extraction. It is a potent antifibrinolytic drug that both competitively inhibits the conversion of plasminogen to plasmin by saturating plasminogen’s lysine binding site [1] and by directly inhibiting plasmin; both of which lead to a reduction in the lysis of fibrin clot, fibrinogen, and other procoagulant factors such as V and VIII [2].