Review Article
Prevention and Management of Gastroesophageal Varices in Cirrhosis
Table 2
Initial medical management of acute variceal bleeding.
| Treatment | Dose | Duration | Details |
| Antibiotics | | | | Ceftriaxone | 1 g IV daily | 5–7 days | Severe cirrhosis Child B/C and/or high suspicion of quinolone resistance | Ciprofloxacin | 400 mg IV or 500 mg oral twice daily | 5–7 days | Mild cirrhosis Child A and low suspicion of quinolone resistance | Norfloxacin | 400 mg oral twice daily | 5–7days | Mild cirrhosis Child A and low suspicion of quinolone resistance | Vasoconstrictors | | | | Octreotide | 50 μg IV bolus, then infusion at 50 μg/hr | 2–5 days | Initial bolus can be repeated in the first hour if bleed not controlled | Terlipressin | 2 mg IV every 4 hr × 48 hr, then 1 mg IV every 4 hr | 2–5 days | Not available in North America | Somatostatin | 250 μg IV bolus, then 250–500 μg/hr | 2–5 days | Not available in North America |
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