Meta Information
ID:tranexamic-acid
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/class/estrogens
Target name:
Estrogens and Progestins (Hormonal Therapy & Contraceptives)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Both tranexamic acid and hormonal therapies (containing estrogen and/or progestin) independently increase the risk of blood clots. Using them together creates an additive and potentially dangerous risk of deep vein thrombosis, pulmonary embolism, or stroke.
Actionable advice:
Tranexamic acid should not be used concurrently with combined hormonal contraceptives or hormone replacement therapy.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Concomitant use of combined hormonal contraceptives
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/condition/thromboembolic-disease-history
Target name:
History of Blood Clots (DVT, PE, Stroke)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Tranexamic acid prevents the breakdown of blood clots. In individuals with a personal history of venous or arterial clots, its use is contraindicated as it can increase the risk of a new thrombotic event.
Actionable advice:
Tranexamic acid should not be taken with a personal or strong family history of blood clots.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Active thromboembolic disease or a history or intrinsic risk of thrombosis
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/class/pro-coagulants
Target name:
Pro-coagulant Medications (e.g., Factor IX complex)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining tranexamic acid with medications that promote blood clotting, such as Factor IX complex or anti-inhibitor coagulant concentrates, significantly elevates the risk of widespread and potentially fatal thrombosis.
Actionable advice:
This combination is contraindicated and should only be managed by a hematologist in specific, monitored situations.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Factor IX complex concentrates, anti-inhibitor coagulant
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/class/thrombolytics
Target name:
Thrombolytic Agents (Clot Busters)
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Tranexamic acid is a direct pharmacological antagonist to thrombolytic drugs (e.g., alteplase). Tranexamic acid prevents clot breakdown, while thrombolytics are administered specifically to dissolve life-threatening clots.
Actionable advice:
These medications should never be taken together; they have directly opposing and mutually negating effects.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Concomitant therapy with tissue plasminogen activators may decrease the
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/condition/renal-impairment
Target name:
Renal Impairment
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Tranexamic acid is cleared by the kidneys. In cases of renal impairment, the drug can accumulate to high levels, increasing the risk of side effects, most notably seizures.
Actionable advice:
Tranexamic acid should be avoided with severe renal impairment; dose reduction is required for mild to moderate impairment under medical supervision.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
if serum creatinine concentration (Cr) is higher than
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/intervention/tretinoin-oral
Target name:
Oral Tretinoin (All-trans retinoic acid)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Concurrent use of tranexamic acid and oral tretinoin, particularly in patients with acute promyelocytic leukemia, has been associated with a potential for catastrophic thrombotic complications.
Actionable advice:
Concomitant use of tranexamic acid and oral tretinoin should be avoided unless specifically directed and monitored by a specialist.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
all-trans retinoic acid (oral tretinoin) may increase the risk
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/condition/defective-color-vision
Target name:
Acquired Defective Color Vision
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Tranexamic acid can cause disturbances in color vision. It is contraindicated in individuals with a pre-existing acquired defect in color vision, as it would be impossible to detect this specific side effect.
Actionable advice:
Tranexamic acid should not be taken with an acquired defect in color vision.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Impaired color vision and other visual disturbances
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/condition/subarachnoid-hemorrhage
Target name:
Subarachnoid Hemorrhage
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
While tranexamic acid can reduce re-bleeding after a subarachnoid hemorrhage, clinical evidence suggests it may increase the risk of cerebral ischemia (stroke) and poor neurological outcomes.
Actionable advice:
Tranexamic acid should not be used for a subarachnoid hemorrhage due to the risk of cerebral infarction.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
LYSTEDA in patients with subarachnoid hemorrhage
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/condition/seizure-disorder
Target name:
Seizure Disorder / Epilepsy
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
High concentrations of tranexamic acid, particularly with rapid intravenous administration or in patients with kidney dysfunction, can lower the seizure threshold by acting as a GABA receptor antagonist.
Actionable advice:
This is best used with extreme caution or avoided in individuals with a history of seizures.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
LYSTEDA in patients with subarachnoid hemorrhage
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Tranexamic acid promotes clot stability (antifibrinolytic), while anticoagulants and antiplatelets prevent clot formation. Their mechanisms are opposing, and concurrent use can counteract the intended therapeutic effects of either agent.
Actionable advice:
These medications are best avoided together unless under the direct supervision of a physician for a specific clinical reason.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Active thromboembolic disease or a history or intrinsic risk of thrombosis
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/class/herbal-anticoagulants
Target name:
Herbal Anticoagulants/Antiplatelets
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Supplements with blood-thinning properties (e.g., ginkgo, garlic, high-dose fish oil, curcumin) work to prevent clotting, while tranexamic acid works to stabilize clots. Using them together may reduce the effectiveness of either the supplement or the medication.
Actionable advice:
It is prudent to discontinue supplements with blood-thinning effects while taking tranexamic acid.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Active thromboembolic disease or a history or intrinsic risk of thrombosis
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
avoid
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
informational
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The absorption and effectiveness of oral tranexamic acid are not significantly affected by food. It can be taken with or without meals, which allows for flexible scheduling.
Actionable advice:
It is generally best taken with food if it causes stomach upset; otherwise, timing with meals is not required.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
LYSTEDA may be administered with or without food
Label source:
FDA label: Tranexamic acid (Lysteda)
Action type:
informational_none