Drug General Information (ID: DDIRP2ZWD4)
Drug Name			Diethylstilbestrol		Drug Info		Tranexamic acid		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Antifibrinolytic Agents
Structure

Mechanism of Diethylstilbestrol-Tranexamic acid Interaction (Severity Level: Major)
Additive thrombogenic effects Click to Show/Hide Mechanism Graph
Drug Name		Diethylstilbestrol				Tranexamic acid
Mechanism		Thrombogenic effects				Thrombogenic effects
Key Mechanism Factor 1
		Factor Name		Thrombogenic effects
		Factor Description		Drug-induced thrombosis disrupts the balance between thrombogenic factors and protective mechanisms and tends to produce thrombosis. Drug-induced thrombosis usually causes venous thrombotic events, and arterial thrombotic events are also noted as a result of drug administration
Mechanism Description		Additive thrombogenic effects by the combination of Diethylstilbestrol and Tranexamic acid

Recommended Action
Management		Caution and close monitoring for thromboembolic adverse effects are recommended if tranexamic acid is prescribed with estrogens or selective estrogen receptor modulators. Patients should be advised to seek medical attention immediately if they experience potential signs and symptoms of blood clots such as chest pain, shortness of breath, hemoptysis, hematuria, sudden loss of vision, and pain, redness or swelling in an extremity.

References
1	Product Information. Cyklokapron (tranexamic acid). Pharmacia and Upjohn, Kalamazoo, MI.
2	van Hylckama Vlieg A, Helmerhorst FM, Vandenbroucke JP, Doggen CJ, Rosendaal FR "The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study." BMJ 339 (2009): b2921.[PMID: 19679614]
3	Gomes MP, Deitcher SR "Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy: a clinical review." Arch Intern Med 164 (2004): 1965-76.[PMID: 15477430]