From the Guidelines
Tranexamic acid (TXA) should not be used to stop a lower gastrointestinal bleed outside of clinical trials. The use of TXA in acute lower gastrointestinal bleeding is not supported by strong evidence, and its effectiveness in this setting is uncertain 1. While TXA has been shown to reduce mortality in patients with upper GI bleeding, the evidence for its use in lower GI bleeding is limited and inconclusive. The British Society of Gastroenterology guidelines suggest that TXA should only be used in clinical trials for acute lower GI bleeding, pending the results of the HALT-IT trial 1.
- The potential benefits of TXA in stopping lower GI bleeds are outweighed by the risks of thromboembolic events, such as deep vein thrombosis and pulmonary embolism 1.
- The European Society of Intensive Care Medicine clinical practice guideline recommends against the general use of high-dose IV TXA in gastrointestinal hemorrhage due to the high certainty of harms and no clear benefit 1.
- Further research is needed to evaluate the role of TXA in lower GI bleeding, including its potential use as rescue therapy in refractory hemorrhage 1.
From the FDA Drug Label
Tranexamic Acid (TXA) and Lower Gastrointestinal Bleed
There is no information in the provided FDA Drug Label regarding the use of tranexamic acid (TXA) to stop a lower gastrointestinal bleed.
Available Information
- The provided label discusses overdosage symptoms, which include gastrointestinal issues such as nausea, vomiting, and diarrhea 2.
- It does not mention the treatment of lower gastrointestinal bleeding.
Relevant Data
No relevant data is available in the provided label to answer the question about the effectiveness of tranexamic acid in stopping a lower gastrointestinal bleed.
Tables
No relevant tables are available in the provided label to answer the question.
Note: There are no research papers or FDA Drug Labels provided that directly address the question of whether tranexamic acid (TXA) can stop a lower gastrointestinal bleed.
From the Research
Tranexamic Acid for Lower Gastrointestinal Bleeding
- There is limited evidence on the effectiveness of tranexamic acid (TXA) in stopping a lower gastrointestinal bleed 3, 4.
- Most studies have focused on upper gastrointestinal bleeding, with some suggesting that TXA may reduce mortality and bleeding in this context 5, 6.
- The HALT-IT trial, a large international randomized controlled trial, aimed to provide reliable evidence on the effects of TXA in acute upper and lower GI bleeding, but the results are not yet fully reported 4.
- Currently, there is no conclusive evidence to support the use of TXA as a standard treatment for lower gastrointestinal bleeding.
Available Evidence
- A systematic review and meta-analysis of randomized controlled trials found that TXA significantly reduced the rates of continued bleeding, urgent endoscopic intervention, and mortality in patients with upper gastrointestinal bleeding, but the effects on lower gastrointestinal bleeding were unclear 3.
- Another systematic review found that TXA may reduce all-cause mortality in upper gastrointestinal bleeding, but the evidence was limited by the small size and methodological weaknesses of the included trials 6.
- A review of the literature on TXA for upper gastrointestinal bleeding suggested that it may be appropriate as an adjuvant treatment, but careful evaluation of thromboembolic risk and dosage is necessary 7.
Gaps in Evidence
- There is a need for further research on the effectiveness and safety of TXA in lower gastrointestinal bleeding.
- The results of the HALT-IT trial are awaited to provide more definitive evidence on the use of TXA in acute GI bleeding, including lower GI bleeding 4.