Medwave
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Spontaneous epistaxis is one of the most frequent problems in emergency services. New treatment alternatives have emerged, including topical tranexamic acid. However, there is controversy about the actual efficacy of this alternative. ⋯ We identified five systematic reviews that analyzed only one primary study, corresponding to a randomized trial. We concluded it is not clear whether topical tranexamic acid has any impact on hemostasis or risk of rebleeding because the certainty of the evidence is very low. On the other hand, its use could increase adverse effects.