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Suggest Treatment For Persistent Nose Bleeds While On Xarelto And Aspirin

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Posted on Thu, 12 Jan 2017
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?
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Answered by Dr. Panagiotis Zografakis (36 minutes later)
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!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Panagiotis Zografakis (7 minutes later)
Isn't warfarin even worse with uncontrolled bleeding?
doctor
Answered by Dr. Panagiotis Zografakis (8 minutes later)
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!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3817 Questions

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Suggest Treatment For Persistent Nose Bleeds While On Xarelto And 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!