Kamhieh Y, et al. - Experts conducted a systematic review of the use of systemic and topical tranexamic acid in epistaxis and a comparative review of its use in other specialties. As a WHO ‘essential medicine’, tranexamic acid was a powerful, readily available tool, the use of which in epistaxis has been limited by uncertainty over its effectiveness and its safety profile. Two RCTs demonstrated significant reduction in severity and frequency of recurrent epistaxes in patients with hereditary haemorrhagic telangiectasia.