Drug interactions
Reteplase + Tranexamic acid
Severity: Moderate
Reteplase and Tranexamic acid: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Reteplase is a thrombolytic that works by converting plasminogen to plasmin, while tranexamic acid blocks plasminogen binding to fibrin. The two act in opposition, so thrombolytic efficacy may be reduced. Tranexamic acid is sometimes used on purpose to reverse thrombolytic-related bleeding.
What this interaction means in plain words
Reteplase and Tranexamic acid can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Pharmacodynamic antagonism: tranexamic acid blocks lysine-binding sites on plasminogen, preventing fibrin-targeted plasmin generation by reteplase.
What to do
Do not give together when thrombolysis is the goal. If reteplase-associated serious bleeding occurs, tranexamic acid may be used deliberately, with monitoring for rethrombosis.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Tranexamic acid
- Dienogest / estradiol valerate + Tranexamic acid Contraindicated
- Ethinyl estradiol-drospirenone + Tranexamic acid Contraindicated
- Ethinyl estradiol-levonorgestrel + Tranexamic acid Contraindicated
- Ethinyl estradiol-norgestimate + Tranexamic acid Contraindicated
- Ethinylestradiol + Tranexamic acid Contraindicated
- Mestranol + Tranexamic acid Contraindicated
Frequently asked questions
Can I take Reteplase with Tranexamic acid?
MediHelp rates the interaction as moderate. Reteplase and Tranexamic acid can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Reteplase is a thrombolytic that works by converting plasminogen to plasmin, while tranexamic acid blocks plasminogen binding to fibrin. The two act in opposition, so thrombolytic efficacy may be reduced. Tranexamic acid is sometimes used on purpose to reverse thrombolytic-related bleeding.
How serious is the interaction between Reteplase and Tranexamic acid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not give together when thrombolysis is the goal. If reteplase-associated serious bleeding occurs, tranexamic acid may be used deliberately, with monitoring for rethrombosis.
What other medicines interact with Tranexamic acid?
MediHelp also lists interactions of Tranexamic acid with, for example, Dienogest / estradiol valerate, Ethinyl estradiol-drospirenone, Ethinyl estradiol-levonorgestrel. The full list is on the Tranexamic acid page.
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