NSAIDS and Blood Thinners

Medical Q&A [Moderated]
1

Hi Docs,

I am on Xarelto due to a PE and DVT from a couple years ago. Hematologist says it is up to me whether or not I continue Xarelto, but recommends that I continue because she thinks the risk of another DVT is greater than the bleeding risks associated with blood thinners. I have had no bleeding problems since I started taking Xarelto. There were no obvious causes of the DVT such as surgery or long plane rides (although I have a desk job) and none of the blood work indicates a genetic or other cause of the DVT. I know that I should not take NSAIDS with blood thinners because it increases the bleeding risks, but Tylenol doesn’t help with pain for me. Hematologist says I can take ibuprofen occasionally for aches and pains, but has not defined what that means as far as dose and frequency. I try to avoid it unless I have a significant pain and have limited it to one 800 mg dose and then just deal with any pain that remains.

Do you have any knowledge about how often and what dose of ibuprofen is not too risky to take while on blood thinners?

Is there a risk difference between oral and topical NSAIDS when taken with blood thinners?

Thank you,

-Jim

2

Unfortunately, we cannot answer a question like this without being your actual physicians. You’re going to have to confirm with your hematologist or primary care doc for specific doses given your medical history.

To answer your last question, there is some inhibition of clotting factors even with topical NSAIDs but it is thought to be very slight. You’d have to double check with your hematologist on that one as well, as he/she knows your medical history better than we do.

3

That is understandable.

Thank you for your help.