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Condition

Variceal Bleeding

Variceal bleeding happens when swollen veins in the food pipe or stomach, enlarged by high pressure in the liver's blood supply, tear and bleed. The evidence is strongest for terlipressin: trials found that people with acute bleeding who received it were less likely to die than those given placebo, roughly a third lower relative risk. That result covers deaths from any cause during acute bleeding, and little other research on this condition has been reviewed here so far.

Sources: PMID 30508958; PMID 12492732

Supplements studied
0
Medicines and peptides
1
Graded outcomes
2
No supplement studies yetWe haven’t found supplement studies for Variceal Bleeding. The medicines and peptides studied for it are listed below.

Prescription medicines and peptides studied, for context

These are not supplements. Most need a prescription, and some are research compounds with no approved use.

1 medicine or peptide

Terlipressin (Terlivaz)

Terlipressin (Terlivaz): outcomes studied for Variceal Bleeding
GradeOutcomeEffectSizeStudiesPeopleStudies list
Bleeding Control (Variceal)

2018 meta-analysis (30 RCTs, 3344 patients): Terlipressin significantly improved bleeding control within 48h vs no vasoactive drug (OR 2.94, P=0.0008). Reduced need for emergency procedures (RR 0.72 vs placebo).

Improves (the measure goes up)Large effect8 studies

Studies that measured bleeding control (variceal)

and 5 more on the Terlipressin (Terlivaz) page

Mortality Reduction (Variceal Bleeding)

Cochrane meta-analysis (7 RCTs, 443 patients): Terlipressin reduced all-cause mortality vs placebo (RR 0.66, 95% CI 0.49-0.88). 34% relative risk reduction. The only vasoactive agent proven to reduce mortality in acute variceal hemorrhage.

Improves (the measure goes down)Large effect6 studies

Studies that measured mortality reduction (variceal bleeding)

and 3 more on the Terlipressin (Terlivaz) page

Key findings

  • Bleeding Control (Variceal)Terlipressin (Terlivaz)Improves (the measure goes up)
  • Mortality Reduction (Variceal Bleeding)Terlipressin (Terlivaz)Improves (the measure goes down)

Safety notes in the studies

  • 34% relative risk reduction.

Studies cited

8 studies from PubMed

  1. Terlipressin for the treatment of hepatorenal syndrome: a meta-analysis of randomized controlled trials.European journal of gastroenterology & hepatology, 2025 · PMID 40207491
  2. Multisystem hemodynamic effects of terlipressin in cirrhosis: A scoping review.Journal of critical care, 2025 · PMID 39955856
  3. Effectiveness of Terlipressin on Modulation of Portal Vein Pressure after Hepatic Resections in Non-Cirrhotic Patients. A Systematic Review and Meta-Analysis of Randomised Controlled Trials.Chirurgia (Bucharest, Romania : 1990), 2020 · PMID 33378629
  4. Role of Terlipressin in Cirrhotic Patients with Ascites and without Hepatorenal Syndrome: A Systematic Review of Current Evidence.Canadian journal of gastroenterology & hepatology, 2020 · PMID 32676484
  5. Terlipressin for the treatment of acute variceal bleeding: A systematic review and meta-analysis of randomized controlled trialsMedicine (Baltimore), 2018 · PMID 30508958
  6. Pharmacology, clinical efficacy and safety of terlipressin in esophageal varices bleeding, septic shock and hepatorenal syndromeExpert Rev Gastroenterol Hepatol, 2008 · PMID 19072411
  7. Systematic review: terlipressin in acute oesophageal variceal haemorrhageAliment Pharmacol Ther, 2003 · PMID 12492732
  8. Terlipressin for acute esophageal variceal hemorrhageCochrane Database Syst Rev, 2003 · PMID 12535432