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Year : 2020  |  Volume : 6  |  Issue : 3  |  Page : 228-231

Shivering Due to Repeat Dose of Tranexamic Acid: A Peculiar Case Series

Department of Pharmacology, Maulana Azad Medical College, New Delhi, India

Correspondence Address:
Dr. Vandana Roy
Room Number 169, First Floor, Pathology Block, Department of Pharmacology, Maulana Azad Medical College (MAMC), Delhi - 110002
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mamcjms.mamcjms_81_20

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Tranexamic acid (TXA) is a well-tolerated hemostatic agent that has been in clinical use for nearly 60 years. In this report, we describe for the first time 10 patients who experienced adverse reactions to repeat dose of TXA, which were not seen with the first dose. Shivering was found to be the most common adverse reaction. In half of the cases, shivering was associated with low-grade fever. On dechallenge and subsequent administration of steroids and antihistaminic agents, the reactions were controlled. On assessment with the World Health Organization–Uppsala Monitoring Centre scale, the causality was ascertained to be “Probable”.There is no clear postulated mechanism for shivering with TXA. We have postulated that hypersensitivity, fever, and shivering in these patients may be interlinked. In the light of this report, the physicians should take into account that repeated challenge with TXA may lead to adverse reactions in some patients and withdrawing the drug in such patients may be required.

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