What Is the Connection between NSAIDs and Bleeding?

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  • Written By: Madeleine A.
  • Edited By: W. Everett
  • Last Modified Date: 29 March 2020
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The connection between NSAIDs and bleeding is linked to the fact that NSAIDs thin the blood and therefore, promote bleeding. Non-steroidal anti-inflammatory drugs (NSAIDs) are powerful anti-inflammatory medications used in the treatment of arthritis, headache, muscle pain, and fever. These drugs are also effective in relieving menstrual cramps, backaches, and post-surgical pain. People who have stomach ulcers should check with their health care providers before taking NSAIDs, because the risk of bleeding ulcers may be increased.

Another connection between NSAIDs and bleeding stems from numerous studies linking internal bleeding to NSAIDs use. Those who take a daily aspirin to prevent heart attack and stroke may be at risk for developing bleeding stomach ulcers and lower gastrointestinal bleeding. People who take prescription medications known as anticoagulants should not take NSAIDs such as ibuprofen or aspirin unless strictly monitored by their health care professionals. In addition, the connection between NSAIDs and bleeding is so strong, that surgeons order patients to stop taking them at least a week before undergoing surgery to prevent abnormal bleeding during and after the procedure.


Since the connection of NSAIDs and bleeding tendencies is so well established, many people frequently attribute abnormal bleeding to taking aspirin. Although aspirin and other NSAIDs can cause bleeding gums, nosebleeds, and prolonged bleeding from cuts, it should not be assumed that these bleeding episodes are solely the result of taking NSAIDs. Certain medical conditions can cause excessive or abnormal bleeding and need to be ruled out by the health care provider first.

Sometimes, internal bleeding caused by taking NSAIDs does not produce symptoms at first. The bleeding can be gradual and may not appear in the stool or urine. Frequently, symptoms may only be recognized once the patient has lost so much blood that he becomes anemic. Symptoms of anemia include dizziness, lightheadedness, extreme fatigue, and paleness. Abnormal bruising, intolerance to cold, and headache may also be signs of anemia. When these symptoms occur, further medical evaluation such as blood tests or diagnostic x-rays may be recommended to determine the cause of anemia or blood loss.

If stomach ulcers occur as a result of taking NSAIDs, the medications should be discontinued. The health care provider will typically recommend medication to heal the ulcers, such as acid blockers or other medications that can soothe the irritated stomach. Even though NSAIDs can increase the risk of bleeding, they are very effective in treating pain, fever, and inflammation and can be taken for extended periods of time if taken under the supervision of a health care provider.



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Post 3

So if NSAIDs start causing bruising, does that mean that I need to stop taking it?

I hope not because I was finally prescribed an NSAID that relieves my costochondritis symptoms. The only issue is that I've started bruising more than usual and it takes longer for the bruises to go away. I'm going to ask my doctor about this on Monday but I hope I won't have to change medications again.

Post 2

@ysmina-- I'm not sure but my doctor said that the slow-release capsules are more likely to cause bleeding. And I'm guessing that the higher the dose and the longer you use NSAIDs, the higher the risk of bleeding.

I don't think it's a good idea to take NSAIDs for more than six months if you're taking them everyday. I took NSAIDs daily for three months after an injury. My stomach started getting very sensitive after the first month. I also cut my hand while cooking once and my blood was more watery than usual.

Post 1

Is there a threshold dose where NSAIDs start to thin the blood? Will a small dose (like 50mg) thin the blood?

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