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Journal: Anesthesiology Authors: Jashvant Poeran MD, PhD, Director of the Center for Clinical and Outcomes Research, and Associate Professor of Population Health Science & Policy and Orthopedics at the Icahn School of Medicine at Mount Sinai; Calin S. Moucha, MD, Chief of Adult Reconstruction & Joint Replacement Surgery at Mount Sinai Hospital, and Associate Professor of Orthopedics at the Icahn School of Medicine at Mount Sinai; and other coauthors. Bottom Line: The use of the drug tranexamic acid is commonplace in patients undergoing hip or knee replacement surgery to reduce blood loss. However, this drug works by promoting clotting and safety concerns exist when used in certain high-risk patients such as those with a history of heart attacks, seizures, blood clots, strokes/mini strokes, renal disease, or irregular and rapid heart rates. ....