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).


Author: Caroline Rea, RN, BS, MSLast Updated: January 25, 2008
Medical Review: Kathleen Romito, MD - Family Medicine
Steven L. Flamm, MD - Gastroenterology

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