Table 2: Initial medical management of acute variceal bleeding.

TreatmentDoseDurationDetails

Antibiotics
 Ceftriaxone1 g IV daily5–7 daysSevere cirrhosis Child B/C and/or high suspicion of quinolone resistance
 Ciprofloxacin400 mg IV or 500 mg oral twice daily5–7 daysMild cirrhosis Child A and low suspicion of quinolone resistance
 Norfloxacin400 mg oral twice daily5–7daysMild cirrhosis Child A and low suspicion of quinolone resistance
Vasoconstrictors
 Octreotide50 μg IV bolus, then infusion at 50 μg/hr2–5 daysInitial bolus can be repeated in the first hour if bleed not controlled
 Terlipressin2 mg IV every 4 hr × 48 hr, then 1 mg IV every 4 hr2–5 daysNot available in North America
 Somatostatin250 μg IV bolus, then 250–500 μg/hr2–5 daysNot available in North America