Original Article

Terlipressin Treatment for Acute Esophageal Variceal Bleeding: Bolus or Infusion?

Volume 37 · Issue 2 Publish Date: August 25, 2025
Ali Şenkaya ORCID Ferit Çelik ORCID İlkçe Kurtulmuş Akgün ORCID Seymur Aslanov ORCID Alper Uysal ORCID Abdullah Murat Buyruk ORCID Nalan Gülşen Ünal ORCID İlker Turan ORCID Ulus Salih Akarca ORCID Zeki Karasu ORCID
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Turkish Journal of Gastroenterology

Volume 37 · Issue 2

Pages: 208-214

History

Published Online: August 25, 2025

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2025 Ali Şenkaya, Ferit Çelik, İlkçe Kurtulmuş Akgün, Seymur Aslanov, Alper Uysal, Abdullah Murat Buyruk, Nalan Gülşen Ünal, İlker Turan, Ulus Salih Akarca, Zeki Karasu

Ali Şenkaya ORCID
Gastroenterology Outpatient Clinic, İzmir City Hospital, İzmir, Türkiye
Ferit Çelik ORCID
Gastroenterology Outpatient Clinic, İzmir Çiğli Training and Research Hospital, İzmir, Türkiye
İlkçe Kurtulmuş Akgün ORCID
Department of Internal Medicine, Ege University Faculty of Medicine, izmir, Türkiye
Seymur Aslanov ORCID
Gastroenterology Outpatient Clinic, İzmir Medicalpoint Hospital, İzmir, Türkiye
Alper Uysal ORCID
Gastroenterology Outpatient Clinic, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye
Abdullah Murat Buyruk ORCID
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
Nalan Gülşen Ünal ORCID
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
İlker Turan ORCID
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
Ulus Salih Akarca ORCID
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
Zeki Karasu ORCID
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
Şenkaya, A., Çelik, F., Kurtulmuş Akgün, İlkçe, Aslanov, S., Uysal, A., Buyruk, A. M., … Karasu, Z. (2025). Terlipressin Treatment for Acute Esophageal Variceal Bleeding: Bolus or Infusion?. Turkish Journal of Gastroenterology, 37(2), 208–214. https://doi.org/10.5152/tjg.2025.25265
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Abstract

Background/Aims: This study aimed to compare the efficacy of bolus versus infusion administration of terlipressin in patients with acute esophageal variceal bleeding and to elucidate any differences in clinical outcomes between the 2 approaches.

Materials and Methods: This prospective study included patients divided into 2 groups. Group 1 received a 2 mg intravenous (IV) bolus followed by 1 mg IV every 4 hours. Group 2 received a 1 mg IV bolus followed by a 4 mg terlipressin infusion over 24 hours. Clinical and laboratory parameters, hospitalization duration, need for blood product transfusion, rebleeding or mortality within 6 weeks, and drug related side effects were evaluated.

Results: Among the 46 patients, 23 (50%) received terlipressin as an IV bolus (group 1), and 23 (50%) received it as an infusion (group 2). Treatment failure occurred in 4 patients (8.7%), all from group 1, though the difference was not statistically significant (P = .109). Six patients (13%) experienced rebleeding and death within 6 weeks, with no significant differences in clinical outcomes between the groups. No significant differences in creatinine and sodium levels were observed between the groups at baseline or at the end of treat ment (P = .654). Additionally, no difference in the incidence of portal vein thrombosis was noted between survivors and non-survivors (P = 1.000).

Conclusion: As no significant differences in efficacy or safety were observed between bolus and infusion administration, infusion ther apy may be preferred due to its potential benefits in patient comfort and ease of administration.

 

Cite this article as: Şenkaya A, Çelik F, Kurtulmuş Akgün İ, et al. Terlipressin treatment for acute esophageal variceal bleeding: Bolus or infusion? Turk J Gastroenterol. 2026;37(2):208-214.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 37 · Issue 2
Pages 208-214
DOI 10.5152/tjg.2025.25265
History
Published Online August 25, 2025
License
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright
Copyright (c) 2025 Ali Şenkaya, Ferit Çelik, İlkçe Kurtulmuş Akgün, Seymur Aslanov, Alper Uysal, Abdullah Murat Buyruk, Nalan Gülşen Ünal, İlker Turan, Ulus Salih Akarca, Zeki Karasu
Affiliations
Ali Şenkaya ORCID
Gastroenterology Outpatient Clinic, İzmir City Hospital, İzmir, Türkiye
Ferit Çelik ORCID
Gastroenterology Outpatient Clinic, İzmir Çiğli Training and Research Hospital, İzmir, Türkiye
İlkçe Kurtulmuş Akgün ORCID
Department of Internal Medicine, Ege University Faculty of Medicine, izmir, Türkiye
Seymur Aslanov ORCID
Gastroenterology Outpatient Clinic, İzmir Medicalpoint Hospital, İzmir, Türkiye
Alper Uysal ORCID
Gastroenterology Outpatient Clinic, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye
Abdullah Murat Buyruk ORCID
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
Nalan Gülşen Ünal ORCID
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
İlker Turan ORCID
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
Ulus Salih Akarca ORCID
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
Zeki Karasu ORCID
Department of Internal Medicine, Division of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye
Cite this Article
Şenkaya, A., Çelik, F., Kurtulmuş Akgün, İlkçe, Aslanov, S., Uysal, A., Buyruk, A. M., … Karasu, Z. (2025). Terlipressin Treatment for Acute Esophageal Variceal Bleeding: Bolus or Infusion?. Turkish Journal of Gastroenterology, 37(2), 208–214. https://doi.org/10.5152/tjg.2025.25265
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