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Drugs that can cause bleeding

People with bleeding disorders should avoid aspirin and other drugs that can cause bleeding. This list of drugs that can cause bleeding does not include drugs that have to be given as injections or intravenous infusions. The generic or “chemical” names are given since the brand names or marketing names differ between countries.

While every effort has been made to include as many drugs as possible, some may be missing. In addition, many non-prescription medications, such as cold remedies, contain aspirin. People with bleeding disorders should check with their hemophilia centre or physician, or consult the pharmaceutical company’s printed instructions before taking any new medication.

Aceclofenac
Acenocoumarol
Acetylsalicylic acid (Aspirin)
Citalopram*
Clopidogrel
Dexibrufen
Diclofenac
Dicoumarol
Escitalopram
Fluoxetine*
Fluvoxamine*
Ibuprofen
Indomethacin
Ketoprofen
Ketorolac 
Lornoxicam
Meloxicam
Nabumetone
Naproxen
Paroxetine*
Phenprocoumon
Piroxicam
Sertraline*
Sulindac
Tenoxicam
Ticlopidine
Warfarin


*These antidepressants have a mild inhibiting effect on the platelet function, which may increase the bleeding tendency. However, since they are less harmful than most other antidepressants in other respects, it is possible to try the medication by starting at a low dose and carefully increase it. Many patients will tolerate these drugs well.

Herbal drugs (phytomedicines) that can cause bleeding

While every effort has been made to include as many herbal drugs as possible, some may be missing. Some herbal medicines have been reported in association with bleeding, but in these cases the patient also took regular drugs that could have caused the bleeding or that the documentation in other respects was weak. These have not been included in this list.

People with bleeding disorders should check with their hemophilia centre or physician, or consult the pharmaceutical company’s printed instructions before taking any new herbal drug.

Ginkgo biloba
Garlic in large amounts
Ginger (not dried ginger)
Ginseng (Asian)
Feverfew
Saw Palmetto (Serenoa repens)
Willow bark

Prepared by Sam Schulman, MD
Updated February 2010 

 

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