Can Tranexamic Acid (TXA) stop gastrointestinal bleeding?

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Last updated: January 27, 2025View editorial policy

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From the Guidelines

Tranexamic acid (TXA) is not recommended as a routine treatment for gastrointestinal bleeding due to limited evidence of its effectiveness and potential risks.

Key Points

  • The use of TXA in gastrointestinal bleeding is not supported by strong evidence, with some studies suggesting a potential benefit in reducing mortality, but others finding no significant effect 1.
  • The British Society of Gastroenterology guidelines suggest that TXA may be considered in clinical trials, but its use is not recommended outside of this setting due to uncertainty about its effectiveness and potential risks 1.
  • Other guidelines, such as those from the European Association for the Study of the Liver, recommend against the routine use of TXA in patients with cirrhosis undergoing invasive procedures or with active variceal bleeding 1.
  • Some studies suggest that TXA may be beneficial in specific patient populations, such as those with hereditary hemorrhagic telangiectasia and mild GI bleeding, but the evidence is limited 1.
  • Further research is needed to fully understand the role of TXA in gastrointestinal bleeding, including its potential benefits and risks, and to identify which patients may be most likely to benefit from its use 1.
  • Older studies have shown mixed results, with some suggesting a potential benefit of TXA in reducing the need for surgical intervention and mortality in ulcer bleeding patients, but these findings are not consistent across all studies 1.

From the FDA Drug Label

Tranexamic Acid (TXA) and Gastrointestinal Bleeding

There is no direct information in the provided FDA Drug Label regarding the use of Tranexamic Acid (TXA) to stop gastrointestinal bleeding.

Reported Symptoms of Overdosage

The label does report symptoms of overdosage, which include gastrointestinal symptoms such as:

  • Nausea
  • Vomiting
  • Diarrhea However, these symptoms do not provide information on the use of TXA to stop gastrointestinal bleeding 2.

Lack of Relevant Information

The provided FDA Drug Label does not contain relevant information to answer whether Tranexamic Acid (TXA) can stop gastrointestinal bleeding. There is no mention of its effectiveness in treating or stopping gastrointestinal bleeding 2.

From the Research

Effectiveness of Tranexamic Acid in Gastrointestinal Bleeding

  • Tranexamic acid has been studied for its potential to reduce gastrointestinal bleeding, with mixed results 3, 4, 5, 6, 7.
  • Some studies suggest that tranexamic acid may reduce mortality and rebleeding in patients with upper gastrointestinal bleeding 3, 4, 5, 7.
  • However, other studies have found no significant difference in death from gastrointestinal bleeding between tranexamic acid and placebo groups 6.

Benefits and Risks of Tranexamic Acid

  • The benefits of tranexamic acid in gastrointestinal bleeding may include reduced mortality and rebleeding 4, 5.
  • The risks of tranexamic acid include thromboembolic events, such as myocardial infarction, pulmonary embolism, and cerebral infarction 3, 6.
  • The overall risk of thromboembolic events with tranexamic acid is still unclear, with some studies suggesting an increased risk 6 and others finding no significant difference 3, 5.

Current Recommendations

  • Based on the available evidence, tranexamic acid cannot be recommended for routine use in gastrointestinal bleeding outside the context of a randomized trial 6.
  • Further studies are needed to fully understand the effects of tranexamic acid in gastrointestinal bleeding and to determine its potential role in treatment 3, 4, 5, 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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