UMEM Educational Pearls

Category: Pharmacology & Therapeutics

Title: Tranexamic Acid in Anterior Epistaxis

Keywords: anterior epistaxis, tranexamic acid, antifibrinolytic (PubMed Search)

Posted: 2/6/2014 by Ellen Lemkin, MD, PharmD
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Tranexamic Acid (TXA) topically applied was compared to anterior nasal packing in 216 patients with acute anterior epistaxis. Cotton pledgets (15 cm) soaked in injectable TXA (500 mg/5 ml) were inserted into the bleeding nostril and removed after bleeding had arrested. This was compared to standard anterior packing.


                                                                   TXA            Anterior packing

% pts bleeding stopped in 10 min:           71%           31.2%                

Discharge after 2 hours                           95.3%           6.4%

Rebleeding in 24 h hours                          4.7%        11%

Satisfaction scores                                    8.5               4.4


Bottom line: topical tranexamic acid looks promising for control of uncomplicated anterior epistaxis.


Zahed R, Moharamzadeh P, AlizadeArasi S, Ghasemi A, Saeedi M. A new and rapid method for epistaxis treatment using injectable form of tranexamic acid topically: a randomized controlled trial. AJEM 2013 (31):1389-92.