From the Research
For epistaxis management using Afrin (oxymetazoline) and TXA (tranexamic acid) soaked gauze, keep the packing in place for approximately 15-30 minutes, as supported by the most recent and highest quality study 1.
Key Considerations
- The combination of Afrin and TXA works effectively due to Afrin's vasoconstrictive properties and TXA's ability to inhibit fibrinolysis, creating a dual mechanism to stop bleeding.
- After applying gentle pressure by pinching the soft part of the nose, the medicated gauze should remain until bleeding has stopped completely.
- If bleeding persists after 30 minutes, medical attention should be sought.
Preparation and Application
- Use standard gauze soaked in a combination of Afrin nasal spray and liquid TXA (typically 500 mg/5mL concentration).
- Apply the medicated gauze to the affected nostril, ensuring it is in contact with the bleeding site.
Post-Removal Care
- Avoid vigorous nose blowing, strenuous activity, and hot showers for 24 hours to prevent rebleeding.
- Apply petroleum jelly to the inside of the nostrils to help prevent drying and further bleeding.
Evidence Summary
- A 2025 study published in The American Journal of Emergency Medicine 1 compared the efficacy of oxymetazoline, tranexamic acid, and epinephrine-lidocaine combination in treating epistaxis, finding oxymetazoline to be superior in achieving rapid hemostasis.
- Other studies, such as those published in 2021 2 and 2020 3, provide additional insights into the effectiveness of tranexamic acid and oxymetazoline in managing epistaxis, but the 2025 study 1 is the most recent and highest quality evidence available.