bleeding gums

[DIB69]

I take 20mg of Rivaroxaban for paroxysmal AF with my main meal in the evening. I've noticed that my gums bleed when I clean my teeth just prior to bedtime. However, no bleeding occurs in the morning when I clean my teeth. Clearly there's a shorter period between taking my medication and brushing my teeth in the evening and I wonder if this might be the reason for the bleeding. Has anyone else experienced this? I'm on no other prescribed meds.

[BobD Volunteer]

Bleeding gums are down to gum disease not anticoagulants I'm afraid.They just highlight the problem. Been there still suffering . Find a good hygeinist and go regularly.

[Paulbounce]

Hi Dib.

Bob D wrote

"Bleeding gums are down to gum disease not anticoagulants I'm afraid.They just highlight the problem. Been there still suffering . Find a good hygeinist and go regularly"

Nothing much to add really. It could be periodontitis - Floss every day and clean your teeth for at least two minutes twice a day.

Sign of getting older I'm afraid. I suggest you use a 'soft' tooth brush - your hygenist will be able to point you in the right direction.

Just one last thing. Gum disease can affect your heart and afib. Get a scale and polish as soon as you can.

I hate going to the dentist - plus they charge the earth but worth doing

Paul

[Singwell]

Agree wuth Bob and mu gums bleed more at night too. Corsodyl moth rinse helps, also using a sonic toothbrush. Due to pandemic and no dental appointments for two years my gums are in a sirry state but the sonic brushing really helps

[Suebo2]

Thinking outside the box- by the morning your guns have had a good 10 hours of rest. Then face 10 hours of ‘abuse’ and many people clean their teeth a little harsher in the evening. All the above comments great, and make sure that you attend the dentist regularly. Take care.

[beach_bum in reply to Suebo2]

I also concur. And if it's any consolation, my gums are in great shape. Fortunately, my veterans plan allows for twice annual deep cleaning and polishing, and I have always brushed and glossed after easy meal, and also use a spin brush and a waterapic. Ya,, sounds like overkill,,but I hate going to the dentist/hygienist, so I try and minimize my time in the chair.I also noticed bleeding after starting Xeralto, and they said "it happens, don't brush so hard" so I eased up, and the bleeding stopped...ya ya, a tad overzealous, but like I said...no offense to Dentists and hygienists...and NO where in the reply did I refer to hygienists as "paid torturers" or "Satin spawn" , but I do dislike going 😜

[CDreamer]

Get a dentist with a very thorough hygienist. The consequences of bleeding gums are numerous and include AF and heart disease. I had to have extensive treatment from a specialist in 2004 - lost several teeth and cost a fortune for gum treatment but it was worth it. Don’t let it get as bad, treat early.

[Rosemaryb1349]

My dentist recommended Peroxyl mouthwash for my bleeding gums which has worked brilliantly for years.

[jimlad2]

I was prescribed Edoxaban (part of the same family of drugs) for the same reason nearly 2 years ago. I take it around 7-8 pm and immediately started suffering the same bleeding problem before going to bed. Like you my morning brushing routine is clear.

[DIB69 in reply to jimlad2]

I'm convinced there's a correlation, especially as both my dentist and dental hygienist say my teeth and gums are in good shape. Also, apart from the strictest period of lockdown, I have managed to see both throughout the last two years.

[Oranges1937]

I've had paroxysmal AF since 2014 and been on Apixaban since then. My gums used to bleed when brushing, morning and evening. I usually visit the dentist every six months and have had no problems with gum disease so I thought it must be the Apixaban.

I tried various toothpastes and mouthwashes but they made no difference

I went to the dentist last week for the first time since 2019 and was told that everything was fine (no gum disease or plaque).

Around 8 months ago I started to take a magnesium supplement to see if it would ease the AF symptoms. My gums have not bled since. Could be a coincidence but might be worth a try.

[DIB69 in reply to Oranges1937]

Thank you Oranges1937, I see my dentist and hygienist twice a year and have also been told that I have no gum disease. I have also been taking magnesium glycinate for a few years which has helped with a number of things but seemingly not bleeding gums. I remain confined that it's the Rivaroxaban and shall follow up with my GP as a starting point.

[Vanna-C]

When I was in hospital, they changed the time of my Rivaroxaban to the evening, and I then had really prolific bleeding when cleaning my teeth. Now, I clean my teeth first thing in the morning, and take the anti coagulant with breakfast. In the evening I only have a slight hint of bleeding when I clean my teeth. Much better!

[Chris1945]

Hi, I received an email (presumably from the 'editors') inviting me to reply to this post for my thoughts on Apixaban which I've often mentioned on this forum. I can only speak for myself, but I'm actually trying to get off the stuff! Within a couple of weeks of starting it, I was experiencing severe joint pain in my hands which gradually, over time, got worse and I now have pain just about everywhere on the old bod! Following a consultation with a Rheumatologist, she has confirmed that in some people, joint pain from Apixaban is indeed a possibility. So it's entirely up to you, hope it all works out well for you..... good luck x

[willywombat44]

Have been using a Waterpik and electric toothbrush for a number of years and on my last visit to my dentist he said that if I had any bleeding when brushing it would be entirely due to the Apixaban.On another note I have been on Apixaban (2 a day) since 2014 with no problems but in June 2020 I asked to go on Rivaroxaban (1 a day) instead.

Four months later I had very bloody urine for 6 days. All possible tests found no reason for it.

I went back on to Apixaban.

[mjames1]

I also had a bleeding issue with once a day 20 mg Rivaroxaban and it went away when I switched to 5 mg Eliquis, twice a day. My non professional theory is that while the once a day dosing is convenient, the drug delivery is not as even as with twice a day Eliquis. Can't hurt to ask your doc to switch and see what happens. Eliquis has been getting good reviews vs Rivaroxaban recently which may also warrant a switch.

[DIB69 in reply to mjames1]

Thank you for your your reply mjames1, after reading this and one or two other similar responses I shall contact my GP . It is highly convenient to only take one small tablet a day (Rivaroxaban) but the bleeding is a concern and sort of suggests that if it's happening with the gums there's a risk of bleeding elsewhere.

[mjames1]

"Apixaban (Eliquis) users had significantly lower rates of ischemic stroke or systemic embolism than those on rivaroxaban (Xarelto, 6.6 vs 8.0 per 1,000 person-years, HR 0.82, 95% CI 0.68-0.98), according to researchers led by Michael Fralick, MD, PhD, of Brigham and Women's Hospital in Boston, reporting online in the ...@

[mjames1]

To update my previous responses. I thought switching from xarelto to Elliquis stopped my bleeding issue but it's now back on Elliquis. I read that Dilitiazem may increase the effect of both xarelto and elliquis. So maybe that is it, or maybe it's something else.