ISSUE 4 AUGUST
Reproduced with permission from Therapeutic Goods Administration (TGA) Medicines Safety Update 18 May 2026.
Summary
Cases of medication errors have been identified internationally where tranexamic acid injection was inadvertently administered to the spinal cord (intrathecally or epidurally), resulting in severe pain, seizures, cardiac arrhythmias and deaths.
Injectable tranexamic acid should only be administered intravenously and must not be given intrathecally or epidurally.
Tranexamic acid is a clotting medicine that helps to control bleeding. Intravenous tranexamic acid is used during or after surgical procedures.
Most of the administration errors involved mix-ups of vials or ampoules resulting in administration of tranexamic acid instead of the intended injectable local anaesthetic (e.g., bupivacaine, levobupivacaine, prilocaine). At particular risk are procedures that may include intravenous injection of tranexamic acid along with intrathecally administered injectable products.
What health professionals should do
To minimise the risk, health professionals should consider taking preventative measures with both storage and administration of tranexamic acid.
It is highly recommended that syringes containing tranexamic acid be clearly labelled for intravenous use only. This will help to prevent any mix-ups during administration.
Additionally, it is advised that tranexamic acid injectables be stored separately from injectable local anaesthetics. This segregation will further reduce the risk of incorrect administration and enhance patient safety.
See the full article on the TGA website.
