Pharmacologic Prevention of Rebleeding

Pharmacologic therapy used during acute variceal bleeding may control the bleeding episode, minimized transfusion requirements, and prevent early rebleeding. Several options for pharmacologic therapy exist in this setting and include: vasopressin in combination with nitroglycerin, terlipressin, somatostatin, and octreotide. Metoclopramide and domperidone may also be useful but require additional study. At present, octreotide, administered intravenously as soon as variceal bleeding is suspected, is favored.