107 patients scheduled for total hip arthroplasty without the use of postoperative drains were randomized to be administered topical tranexamic acid (TXA) with or without the addition of diluted epinephrine (DEP). The purpose of this study was to evaluate if the addition of DEP to topical TXA significantly reduced haemtological parameters associated with blood loss and allogeneic blood transfusion. The incidence of deep vein thrombosis and pulmonary embolism were also monitored. Calculated total blood loss and hidden blood loss were significantly lower in the TXA+DEP group compared to the TXA group. No difference was observed between groups for intraoperative blood loss. The difference between groups in the incidence of transfusion was not statistically significant.