Drug therapy for haematuria in palliative care

For empirical management of troublesome haematuria in patients with palliative care needs when other options are inappropriate or ineffective, use:

Use tranexamic acid with caution because there is a risk of intravesicular clotting and resulting clot retention, particularly if the bleeding is known to originate from the kidney or ureters. Dose reduction is required in a patient with kidney impairment as tranexamic acid is excreted in the urine unchanged.

If no improvement in symptoms is seen after 1 week, stop the tranexamic acid.

Finasteride may be used if bleeding from the prostatic bed is suspected—seek expert advice.