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April 1989

Problems in the Use of Tranexamic Acid by Ophthalmologists

Author Affiliations

New York, NY

Arch Ophthalmol. 1989;107(4):486-487. doi:10.1001/archopht.1989.01070010500006

To the Editor.  —In the September 1988 Archives, Uusitalo and coworkers1 provided additional evidence of the effectiveness of tranexamic acid in preventing rebleeds after traumatic hyphemas. Unfortunately, there are several problems regarding its use of which ophthalmologists in the United States should be aware.

  1. It is not a labeled indication. Although various studies have been performed in the Scandinavian countries over the last 13 years showing the effectiveness of tranexamic acid (some of which are referenced in the article by Uusitalo and coworkers), the drug is not approved in the United States for use in the treatment of hyphemas. In Canada, it is approved for this use.

  2. The Food and Drug Administration (FDA) Drug Bulletin of April 19872 announced the release of tranexamic acid. Over half of the bulletin was devoted to the potential ophthalmologic side effects. It states the following:

The labeling of tranexamic acid warns that focal

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