This study evaluated oral tranexamic acid as an adjunct in controlling epistaxis and preventing or reducing recurrent epistaxis. Patients entered into the trial were randomized in double blind fashion to placebo or tranexamic acid 1 g, 3 times daily. Treatment continued for 10 days. The patients were reviewed daily and any rebleeds categorized into minor, moderate or severe according to length and briskness of bleed and subsequent treatment. Of the 89 patients who completed the course of tablets, 25 (57%) in the placebo group and 21 (47%) in the treatment group had a rebleed. More patients in the placebo group had minor and moderate rebleeds, but the same number of patients in the placebo and treatment groups had severe rebleeds; this difference was not statistically significant. Oral tranexamic acid is, therefore, of no proven value as an adjunct in the treatment of epistaxis in patients requiring hospital admission.