Therapy

Consider tranexamic acid ^a for patients likely to rebleed ^d (3 to 6 g iv daily for 3 days, followed by 3 to 6 g by mouth daily for 3 to 5 days) 

Why?

• It reduces death, without clearly affecting rebleeding or need for emergency surgery ^a
• Thromboembolic events are rare - 0.04% have an event (mainly superficial thrombophlebitis) ^a

Tranexamic acid reduces mortality

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
upper GI bleed a	tranexamic acid	placebo	death	10%	0.60 (0.40 to 0.89)	26 (17 to 97)