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Suggest Treatment For Persistent Nose Bleeds While On Xarelto And Aspirin
Posted on
Fri, 23 Dec 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Fri, 23 Dec 2016
Answered on
Thu, 12 Jan 2017
Last reviewed on
Question : My husband is on both Xarelto and low dose aspirin and is suffering with nosebleeds that can take up to 3 hours to stop. Should he stop taking the aspirin?
Brief Answer:
why does he take both?
Detailed Answer:
Hello,
what is the reason for taking both xarelto and aspirin? If both are absolutely necessary (for example a patient with metallic heart valve and a 'fresh' stent in a coronary artery) then perhaps his doctor could consider switching from xarelto to warfarin. Stopping such drugs without your doctor's approval is not recommended.
Kind Regards!
why does he take both?
Detailed Answer:
Hello,
what is the reason for taking both xarelto and aspirin? If both are absolutely necessary (for example a patient with metallic heart valve and a 'fresh' stent in a coronary artery) then perhaps his doctor could consider switching from xarelto to warfarin. Stopping such drugs without your doctor's approval is not recommended.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Isn't warfarin even worse with uncontrolled bleeding?
Brief Answer:
it depends...
Detailed Answer:
Warfarin's effect can sometimes be unpredictable because various factors affect it. But it can be measured (Prothrombin time or INR) and be adjusted accordingly. Xarelto can be assessed also but it's not as easy as with warfarin. It's true that the combination of anticoagulants (like xarelto or warfarin) and anti-platelet drugs (like aspirin) increases the risk of bleeding.
So it's not an easy decision. Warfarin can be monitored, xarelto can't as easily. Both may cause bleeding. Bleeding caused by warfarin can be reversed with vitamin K (although it's not always necessary). Bleeding caused by xarelto is not easy to manage. So you'll have to talk with his doctor about the necessity of double treatment (anticoagulant and antiplatelet agent). If double treatment is required then perhaps trying with warfarin is worth the effort.
Kind Regards!
it depends...
Detailed Answer:
Warfarin's effect can sometimes be unpredictable because various factors affect it. But it can be measured (Prothrombin time or INR) and be adjusted accordingly. Xarelto can be assessed also but it's not as easy as with warfarin. It's true that the combination of anticoagulants (like xarelto or warfarin) and anti-platelet drugs (like aspirin) increases the risk of bleeding.
So it's not an easy decision. Warfarin can be monitored, xarelto can't as easily. Both may cause bleeding. Bleeding caused by warfarin can be reversed with vitamin K (although it's not always necessary). Bleeding caused by xarelto is not easy to manage. So you'll have to talk with his doctor about the necessity of double treatment (anticoagulant and antiplatelet agent). If double treatment is required then perhaps trying with warfarin is worth the effort.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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