Clinical algorithms for the prevention of variceal bleeding and rebleeding in patients with liver cirrhosis

Table 2 Recommended vasoactive agents for management of acute variceal bleeding [adapted from the Austrian (Billroth III), European (Baveno VI) and American (Guidance by the AASLD 2017) guidelines][3,17,22]

Regimen	Dosing	Duration of regimen	Further guidance
Somatostatin	Bolus of 500 μg, followed by 500 μg/h via continuous infusion (6 mg/50 mL, infusion rate of 4.2 mL/h)	2-5 d	Bolus can be repeated in case of uncontrolled bleeding
Terlipressin	Bolus of 2mg every 4 h for the first 24-48 h, followed by giving bolus of 1mg every 4 h; Or continuous infusion 2 mg/d; maximum 12 mg/d	2-5 d	Be caution in patients with coronary artery disease, peripheral arterial occlusive disease hyponatremia (< 125 mmol/L), cardiac arrhythmia and severe asthma or chronic occlusive pulmonary disease
Octreotide (somatostatin analogue)	Bolus of 50 μg, followed by 50 μg via continuous infusion	2-5 d	Bolus can be repeated in case of uncontrolled bleeding