Emerging treatments
Tranexamic acid
Tranexamic acid might be a useful adjunct in the management of epistaxis. Evidence from one randomized trial suggests that topical tranexamic acid may be more effective than anterior nasal packing; however, this study requires corroboration.[47] A 2018 Cochrane systematic review found moderate quality evidence that oral tranexamic acid reduces the risk of rebleeding in adult patients. The authors found weak evidence that topical tranexamic acid reduces rebleeding rates. They note that there are only 3 randomized controlled trials looking at the use of tranexamic acid in epistaxis and more research is needed to fully quantify its role.[48] The American Academy of Otolaryngology guideline does not make any recommendations regarding the use of topical or oral tranexamic acid as studies to date are considered of moderate quality and further study is required.[8]
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