From the Guidelines
Tranexamic acid (TXA) is not recommended as a primary treatment to stop a gastrointestinal (GI) bleed, as its effectiveness in this context is uncertain and may vary depending on the severity and cause of the GI bleed.
- The use of TXA in acute GI bleeding has been evaluated in several studies, with mixed results 1.
- A large randomized placebo-controlled trial including 12,009 patients with acute upper gastrointestinal bleeding found no beneficial effect of TXA in reducing mortality due to bleeding, and an increased risk of venous thromboembolic events was observed in the TXA group 1.
- The EASL clinical practice guidelines recommend against the use of TXA in patients with cirrhosis and active variceal bleeding, citing a lack of evidence for its effectiveness and potential risks 1.
- However, TXA may be considered in specific cases, such as in patients with hereditary hemorrhagic telangiectasia (HHT) and mild GI bleeding, although the evidence for its effectiveness in this context is limited 1.
- Overall, the current evidence suggests that TXA should not be used as a primary treatment for GI bleeding, and its use should be considered on a case-by-case basis, taking into account the underlying cause and severity of the bleeding, as well as the potential risks and benefits.
From the FDA Drug Label
Tranexamic Acid (TXA) and Gastrointestinal Bleed
Efficacy of TXA in Stopping Gastrointestinal Bleed
There is no information in the provided FDA Drug Label [ 2 ] that suggests tranexamic acid (TXA) can stop a gastrointestinal bleed. The label only discusses symptoms of overdosage, which may include gastrointestinal issues such as nausea, vomiting, and diarrhea, but does not provide information on the use of TXA for treating gastrointestinal bleeding.
- Symptoms of overdosage:
- Gastrointestinal: nausea, vomiting, diarrhea
- Hypotensive: orthostatic symptoms
- Thromboembolic: arterial, venous, embolic
- Neurologic: visual impairment, convulsions, headache, mental status changes
- Myoclonus
- Rash
Relevant Information
The provided FDA Drug Label [ 2 ] does not contain relevant information to answer the question of whether tranexamic acid (TXA) can stop a gastrointestinal bleed.
From the Research
Effectiveness of Tranexamic Acid in Gastrointestinal Bleeding
- Tranexamic acid (TXA) has been studied as a potential treatment for gastrointestinal bleeding, with evidence suggesting it may decrease rebleeding and mortality in patients with upper gastrointestinal bleeding 3.
- A systematic review of randomized trials found that TXA may reduce all-cause mortality in patients with upper gastrointestinal bleeding, although the evidence was limited by the small size and methodological weaknesses of the included trials 4.
- Another study found that TXA seemed appropriate as adjuvant treatment during upper gastrointestinal bleeding, but noted that patients with gastrointestinal bleeding are often old and have several co-morbidities, requiring careful evaluation of thromboembolic risk and TXA dosage 5.
Studies on Tranexamic Acid in Gastrointestinal Bleeding
- A pilot study found that TXA was beneficial as adjunctive therapy in treating major upper gastrointestinal bleeding in dialysis patients, reducing the rate of early re-bleeding, repeated endoscopic procedures, and blood transfusions needed 6.
- The HALT-IT trial, a large international randomized controlled trial, aimed to provide reliable evidence about the effects of TXA in acute upper and lower GI bleeding, but the results are not yet available in the provided evidence 7.