Tranexamic acid for ACE inhibitor induced angioedema

Am J Emerg Med. 2021 May:43:292.e5-292.e7. doi: 10.1016/j.ajem.2020.10.029. Epub 2020 Oct 21.

Abstract

Tranexamic acid (TXA) is an antifibrinolytic agent which inhibits conversion of plasminogen to plasmin, a key step in kallikrein activation and bradykinin formation. Tranexamic acid is used in prophylactic management of hereditary angioedema; however, evidence for TXA in angiotensin converting enzyme (ACE) inhibitor-induced angioedema (ACEI-AE) is limited. We describe a patient who presented to the emergency department with ACEI-AE who was successfully treated with TXA. This case suggests that TXA may be a beneficial treatment modality in the management of ACEI-AE and warrants further investigation.

Keywords: ACE inhibitor; Angioedema; Bradykinin; Tranexamic acid.

Publication types

  • Case Reports

MeSH terms

  • Angioedema / chemically induced*
  • Angioedema / drug therapy
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects*
  • Angiotensin-Converting Enzyme Inhibitors / pharmacology
  • Antifibrinolytic Agents / administration & dosage
  • Antifibrinolytic Agents / pharmacology
  • Female
  • Humans
  • Lisinopril / adverse effects*
  • Lisinopril / pharmacology
  • Middle Aged
  • Tranexamic Acid / administration & dosage
  • Tranexamic Acid / pharmacology

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antifibrinolytic Agents
  • Tranexamic Acid
  • Lisinopril