Clinical Research Directory

Inclusion Criteria: * Age 18 years and over * Cirrhosis and portal hypertension, * Small oesophageal varices diagnosed within the last 6 months, defined as ≤5 mm in diameter or varices which completely disappear on moderate insufflation at gastroscopy. * Not received a beta-blocker in the last week * Capacity to provide informed consent Exclusion Criteria: * Non-cirrhotic portal hypertension * Medium/large oesophageal varices (current or history \[decreasing in size without curative therapy\]), defined as \>5 mm in diameter * Gastric (IGV and GOV2), duodenal, rectal varices with or without evidence of recent bleeding. * Previous variceal haemorrhage * Previous band ligation or glue injection of oesophageal and/or gastric varices * Red signs accompanying varices at endoscopy * Known intolerance to beta blockers * Contraindications to beta blocker use * Unable to provide informed consent * Child Pugh C cirrhosis * Already receiving a beta-blocker for another reason that cannot be discontinued * Graft cirrhosis post liver transplantation * Evidence of active malignancy without curative therapy planned * Pregnant or lactating women * Women of child bearing potential not willing to use adequate contraception during the period of IMP dosing * Patients who have been on a CTIMP within the previous 3 months * Clinical symptoms consistent with COVID-19