High-dose intravenous tranexamic acid,
does it really help with Prevention of bleeding death within five days in acute gastrointestinal hemorrhage?
research showsGrade D, 34 points. Bleeding death was 222/5,956 (3.7%) versus 226/5,981 (3.8%), absolute difference -0.1 points, RR 0.99 (95% CI 0.82 to 1.18). Venous thromboembolism increased from 0.4% to 0.8%, RR 1.85 (1.15 to 2.98), and seizures from 0.4% to 0.6%, RR 1.73 (1.03 to 2.93).
ads claimBenefits in trauma or postpartum hemorrhage cannot be generalized to GI bleeding.
Useful facts when choosing a product
- Regimen: 1-g loading dose then 3 g over 24 hours.
- It does not replace endoscopic source control.
What the research actually shows
Four-gate review: ① At least 15% attrition ② listed item ③ 72 of 12,009 (0.6%) were outside the primary analysis; survival censoring is not attrition ④ criterion not met. ① Unmasked subjective endpoint ② listed item ③ patients, caregivers, and assessors were masked and the endpoint was death ④ criterion not met. ① Under 200 ② listed item ③ 12,009 randomized ④ criterion not met.
Why this is classified as D (34)
One very large publicly funded null mortality trial with significant harms gives D, 34.
Counterpoint. Primary efficacy was null, but significant prespecified safety harms make the effect E- and warrant a warning.
Rejudgment record. Source checked — Very large mortality RCT with null efficacy and increased VTE and seizures
| Endpoint | H | Hard endpoint - actual events such as death |
| Replication | R1 | Single confirmatory trial |
| Independence | I2 | Decisive evidence is publicly or non-profit funded |
| Effect size | E- | Harm increased in the trials |
| Precision | C0 | The confidence interval leaves room for benefit |
The scoring table and the verdict agree (D).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| Prevention of five-day bleeding death | D | RR was 0.99. |
Cross-check — AI research and Codex final gate
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| HALT-IT Trial Collaborators | International randomized double-blind placebo-controlled trial | 12,009 | UK NIHR HTA | Death due to bleeding within five days | 3.7% vs 3.8%, RR 0.99 (0.82 to 1.18); VTE 0.8% vs 0.4%; seizures 0.6% vs 0.4% | Very large mortality RCT |
Receipt — 2 References
All 2 cited sources were verified for existence at the original page (as of 2026-08-26).
Final verification and publication gate: Codex · Verification cutoff: 2026-08-26 · Corrections: none
Cite this verdict
[Chamgap] No Benefit of High-Dose Intravenous Tranexamic Acid for Preventing Death from Bleeding in Acute Gastrointestinal Haemorrhage — Evidence Grade D·34. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/gut/high-dose-tranexamic-acid-acute-gi-bleeding-death/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
What this document does and does not do
Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.