A randomized double-blind trial of glypressin in the management of acute epistaxis

This is the first randomised double-blind trial of glypressin in the treatment of acute epistaxis, where no localized bleeding point was found and where the patient would normally be treated with a form of nasal packing. It shows a statistically significant benefit with the intravenous drug compared to placebo. In addition, the dose of glypressin used to achieve control appears to be free of major side effects. Acute epistaxis is a common problem, nasal packing is unpleasant and not without side effects, and therefore an alternative form of treatment would have clear advantages. The mechanism of action of glypressin is discussed along with the implications of the results for the future role of glypressin in the treatment of acute epistaxis.