Nebulized Tranexamic Acid Therapy for Hemoptysis Associated with Submassive Pulmonary Embolism

Jayesh A. Dhanani, Jason Roberts, Michael C. Reade

Research output: Contribution to journalArticleOtherpeer-review

1 Citation (Scopus)


Hemoptysis and pulmonary embolism (PE) are life-Threatening pulmonary emergencies that, when present together, create a therapeutic conundrum. We present an illustrative case of a 65-year-old man with unprovoked submassive PE and moderate hemoptysis due to pulmonary infarction. Hemoptysis precluded systemic anticoagulation. Failing a conservative management strategy, we administered nebulized tranexamic acid. After four doses of nebulized tranexamic acid 500 mg, 6 hours apart, hemoptysis had ceased. Systemic anticoagulation with intravenous heparin was then successfully commenced 12 hours after the last episode of hemoptysis. The patient was weaned off high-flow nasal oxygen therapy over the course of the next 5 days with no hemoptysis recurrence. Noting the absence of trial evidence, but good pharmacological rationale and our positive experience, we suggest tranexamic acid is a useful noninvasive treatment option for the management of such conditions. Consent for this publication was obtained from the patient.

Original languageEnglish
Pages (from-to)12-14
Number of pages3
JournalJournal of Aerosol Medicine and Pulmonary Drug Delivery
Issue number1
Publication statusPublished - 1 Feb 2020
Externally publishedYes


  • hemoptysis
  • nebulized
  • pulmonary embolism
  • tranexamic acid

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