Nose beefs

[Koladog]

I wrote a post on May after having 4 nose bleeds after being on Riveroxiban for 6 years. I stopped the anticoagulant for 3 weeks & I now take Apixaban. Have been fine until now when I am on holiday in France in our campervan & have already had 2 bleeds luckily while on site controlled by pressure & ice. I have stopped Apixaban on advice of surgery at home. Has anyone experience or advice about this as I need some help. Thanks

[BobD Volunteer]

As I am sure you understand , anticoagulants do not thin blood so do not make bleeds more likely. They will make any bleeds more difficult to stop as you have found. It sounds like you must have a weakness in your nasal passages which is causing these bleeds so my advice would be to speak to your doctor about a referral to a specialist for investigataion in the long run.

For now you must balance the risks which you are doing by stopping apixaban. The only time I have ever had major nose bleeds has been when given clopidogrel or aspirin which are anti platelets not anticoagulants (whilst in hospital despite my warnings of what would happen) so I do understand. Waking up to a sea of red is no fun.

[Koladog in reply to BobD]

I did see an ENT specialist in May & had an endoscopy of my nose bit he couldn’t see any bleeding point. I will have to manage this I guess while in France unless there is a need to call emergency services.

[Howardl in reply to BobD]

I've been on Apixaban for about 5 years and do get the odd nose bleed usually when I get up from bending over. It happens once in a while so I don't really pay it much attention. I also get a runny nose doing the same if I get up to quick, but it only lasts a second or so. I find Apixaban annoying when shaving so much so I changed to an electric shaver.

[BobD Volunteer in reply to Howardl]

After 16 years on warfarin the only bleeds I get are my teeth but that is down to a life time of NHS dentistry. By the time I found a professional the damage was done and we have been playing hold the fort with gum disease ever since.

[Howardl in reply to BobD]

I had/have the same problem. I have had very, very few bad teeth through decay it's usually gum disease and the only advice I get from the dentists is you have to keep them clean. But some say there is a link between teeth and the heart so who knows.

[BobD Volunteer in reply to Howardl]

Joining Denplan gives me three monthly hygienist appointments which NHS never even offered. This has meant that in the last sixteen years I have not last anymore teeth though there is one looking pretty dodgy.

[Auriculaire in reply to Howardl]

Co enzyme Q10 can help with gum health. This is usually taken as a heart supplement.

[LaceyLady in reply to Howardl]

Yes I’ve heard that. Bacteria is close to the heart.

[pusillanimous in reply to Howardl]

I think it has been proven that there is a link between heart disease oral bacteria and periodontal disease. Therefore it is essential to practice good oral hygiene - correct brushing technique and flossing at least once a day - a prophylaxis by a good dental hygienist every six months is great, but nothing beats excellent daily home care.

[jeanjeannie50]

Take great care and be gentle around your nose area when washing your face and when you first get out of bed no blowing your nose. In fact no blowing your nose at all for now. I'm convinced that when my nose bled I got so stressed about it that my blood pressure would go up and make things a lot worse.

Feel for you.

Jean

[MPA9]

I feel for you. I had a really bad nosebleed after trying the Valsalva manoeuvre in an attempt to stop AF. I ended up having to have my nose cauterised to stop the bleeding. I don’t blow my nose at all now and have been ok for the past 8 months with no further bleeds.

[Koladog]

Thank you everyone for replies. It would be ok if I was at home as I could see the ENT specialist as soon as I had a bleed & then hopefully he could see where it needed cautery We are in France until mid Sept

[JudyMarieC]

I had frequent nosebleeds, most often in the mornings, and blamed it on my cpap therapy and dryness in the house during the winter months. I began taking extra Vitamin C when covid began and strangely enough, the nosebleeds have stopped. I don't know if the Vitamin C had anything to do with it or if it's just coincidence but it might be worth a try. I take 500 mg./day in addition to the small amount that's in my multiple vitamin. I also use a saline nasal spray morning and night. I've been on anticoagulants for about 4-1/2 years. Hope this helps.

[Koladog]

We seem to have left my post about nose bleeds in favour of dental health & heart disease. However I am still interested in any comments about nose bleeds especially when away from the UK on holiday Thanks

[Ramblingross in reply to Koladog]

Hi Koladog....l started with nose bleeds the minute l woke up....discovered after a lot of enquiries that taking Clopadogril and Rivaoxaban together was the cause....

[seasicksurf]

Koladog,

I'm the nose bleed king. I participated in any sporting activity I could when I was young and my shnoz is bent all ways inside and out. I have nosebleeds regularly. I can tell you they most often occur when dehydrated. I, for one, tend to lose my hydration routine when on holiday (especially when flying), I drink less water, and am inclined for a pint or two, which ends up drying out my poor nose mucous membranes severely. Pump up your water/fluids intake and minimize the alcohol. Have a nice holiday.

[Koladog in reply to seasicksurf]

Thank you seasick surf for advice. I do tend to keep hydrated because of the AF and also keep to just I glass of wine even in France & since my last bleed haven’t had a sniff as didn’t really fancy it. So will continue to follow your advice. There is never any warning they just happen this holiday once in the shower & once in the middle of the night. My nose has never been damaged yet 🤣🤣

[SweetAdelyn]

I had nosebleeds and other issues on Xarelto and switched to Lixiana(Edoxaban) over 2 years ago and have had no problems with nosebleeds

[20WildRose19]

I had many nose bleeds when on calcium channel blocker and Apixaban. Now only taking Apixaban and never had a nose bleed.

[GuyThoma]

My advice, from personal experience, rather than professional knowledge is simply to reduce the dose. Plan A would be to reduce the dose from 5.00 mg to the 2.5 mg pill. Plan B would be to experiment by chopping the pill, thus taking a reduced dose until the bleeding stopped. In truth I just bite off 1/3 - 1/4 of the pill and swallow the rest.

To me this is logical, but unsanctioned, however it worked for me. My nosebleeds reduced from one every 2 weeks to zero in 18 months, and I am still getting protection from the Apixaban.

While I am a maverick I have researched the literature, Japanese studies show people taking 2.5 mg of Apixaban and getting sufficient blood clotting protection. As an ex-scientist I muse why everyone needs exactly 5.00 mg. Surely those weighing 65 Kg need less than those weighing 90 Kg?

[van62]

I use Nozohaem, it coagulates the blood, unfortunately not available on NHS though

[Koladog]

Thanks van62 will see if it’s available in France. I take it there’s no effect on your AF