Tranexamic acid for angiotensin-converting enzyme inhibitor-induced angioedema

Gaurav Nitin Pathak; Thu Minh Truong; Abhishek Chakraborty; Babar Rao; Catherine Monteleone

doi:10.15441/ceem.23.051

Tranexamic acid for angiotensin-converting enzyme inhibitor-induced angioedema

Clin Exp Emerg Med. 2024 Mar;11(1):94-99. doi: 10.15441/ceem.23.051. Epub 2023 Aug 1.

Authors

Gaurav Nitin Pathak¹, Thu Minh Truong², Abhishek Chakraborty¹, Babar Rao¹, Catherine Monteleone¹

Affiliations

¹ Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
² New Jersey Medical School, Newark, NJ, USA.

Abstract

Approximately 0.7% of patients taking angiotensin-converting enzyme inhibitors (ACEIs) develop ACEI-induced angioedema (ACEI-IA). With no approved treatments for ACEI-IA, the risk of complications is concerning. Tranexamic acid (TXA) has the potential to prevent intubations and resolve ACEI-IA by inhibiting the downstream production of bradykinin. In this review, we aim to evaluate the safety and efficacy of TXA use in ACEI-IA. We queried the PubMed database for studies involving TXA for ACEI-IA from January 2003 to January 2023. Seven studies met the study inclusion criteria. Our results demonstrate that TXA may improve angioedema symptoms and prevent intubation. In addition, its availability, low cost, and safety profile support its use for improving the symptoms and complications of ACEI-IA in an emergency setting.

Keywords: Angiotensin-converting enzyme inhibitors; Angiotensin-converting enzyme inhibitor–induced angioedema; Bradykinin-mediated angioedema; Drug-induced angioedema; Tranexamic acid.