Beyond the Battlefield: Tranexamic Acid for Non-Trauma-Related Indications

Tranexamic acid (TXA) as an antifibrinolytic agent gained global recognition following the CRASH-2 landmark trial where its role as an antifibrinolytic agent was shown to be a beneficial intervention with proven efficacy in trauma-related hemorrhage. The utility of TXA for non-trauma-related indications is less well established, but the list of indications for its use continues to grow and evolve with varying levels of supporting evidence. Two emerging indications include hemoptysis and gastrointestinal (GI) bleeding; however, current published studies for both potential indications vary in both quality and outcomes, creating uncertainty for pharmacists and physicians. This presentation will provide a general overview of TXA as an antifibrinolytic agent, its relevance to practice, and then delve into the available literature evaluating the use of TXA in hemoptysis and GI bleeding to provide a practical, evidence-informed framework to help guide its use in these two non-trauma settings. Attendees will ideally leave this session equipped with actionable guidance to apply to clinical decision making when determining when TXA should, or should not, be incorporated into a patient’s approach to treatment when presenting to the emergency department with GI bleeding or active hemoptysis.