Vasoconstrictor medications to treat variceal bleeding
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Vasoconstrictor medications to treat variceal bleeding
Medications that constrict small blood vessels and reduce blood flow to the portal vein are used to treat sudden (acute) bleeding from enlarged veins (varices) in the digestive tract (variceal bleeding).
Somatostatin, octreotide, and vapreotide are the main medications used in the United States to treat variceal bleeding. Terlipressin is used in Europe. These medications may stop bleeding by themselves, or they may be used to reduce bleeding long enough for a person's condition to stabilize in preparation for endoscopic treatment.1
These medications also may be used along with endoscopic treatment. One recent study found that vapreotide combined with endoscopic treatment stopped bleeding more effectively than endoscopic treatment alone.2
Side effects of these medications may include:
- Irregular heartbeats (arrhythmias).
- Headache.
- Dizziness.
- Too much sugar in the blood (hyperglycemia).
- Diarrhea.
- Formation of gallstones (with long-term use).
References
Citations
Sanyal AJ (2006). Variceal hemorrhage. In M Wolfe, ed., Therapy of Digestive Disorders, pp. 589–606. Philadelphia: W.B. Saunders.
Calès P, et al. (2001). Early administration of vapreotide for variceal bleeding in patients with cirrhosis. New England Journal of Medicine, 344(1): 23–28.
Credits
| Author | Caroline Rea, RN, BS, MS |
| Editor | Maria Essig |
| Editor | Susan Van Houten, RN, BSN, MBA |
| Associate Editor | Pat Truman, MATC |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Steven L. Flamm, MD - Gastroenterology |
| Last Updated | January 25, 2008 |
| Last updated: | January 25, 2008 |
|---|---|
| Author: | Caroline Rea, RN, BS, MS |
| Reviewed By: | Kathleen Romito, MD - Family Medicine, Steven L. Flamm, MD - Gastroenterology |
| Editors: | Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC |
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