Frequent nose bleeds on Warfarin INR btw 3 and 4.

[hollyhobbi]

Anyone here on Warfarin with an INR target of 3 to 4 who suffers from frequent severe nose bleeds? In March I had 4 visits to A and E with nosebleeds. The last time the Ambulance guys couldn't even get the rapid rhino in my nostril. In the end I was put on an IV and the Dr ended up putting in two rapid rhino's one in each nostril! She had to put an extra large one in the nostril which always starts bleeding first. I managed to see an ENT a few weeks ago and he cauterised two blood vessels but I've had 5 bleeds since. The worst one took an hour of pressure to stop. Any advice for me?

[daisyd]

I used to get nose bleeds, I had to be admitted to hospital once because my inr was 5.0 ish

I had several blood tests but nothing found apart from a high inr, mine should be between 3-4 as I have antiphospholipid syndrome

The thing I do now after cautery is use a very soft tissue, I have a nose clip which I was given in hospital, you can buy them from a well known shopping web site,

Apply ice pack to the back of my neck, don’t forget to sit down and rest, ice pack don’t leave on for more than 10mins

[hollyhobbi in reply to daisyd]

Thanks for replying daisyd. A nose clip sounds good. Presumably it works? The highest my INR was when they checked it in A n E was 4.4.

[Jumper99]

I have an INR between 3 and 4 but I have Antiphospholipid Syndrome so I don’t get nosebleeds even though it’s a high INR. Does your consultant know that you get such frequent bleeds? My first thought is that your INR is too high but then I thought that there must be a good reason for it to be that high if you are bleeding so much. X

[hollyhobbi in reply to Jumper99]

I'm going to my Endocrinologist and Haematologist in early September so I'll be saying it to them both. I had two DVTs one of them while I was on a high dose of Innohep injections. But that was before I was diagnosed with primary hyperparathyroidism with 4 gland hyperplasia which is a genetic Endocrine disorder. One of my sister's has it too. And other members of my family have different glands affected. Both clots were when my blood calcium level was high and before I was diagnosed. So I'm on the Warfarin because I had two DVTs one of them while on anticoagulant treatments.

[Tofino5]

I used to get nosebleeds frequently when I was on warfarin. My INR was very erratic, but the target was 3.5. Even when my INR was over 6 I didn't see any correlation with the INR to nosebleeds. In the emergency room one time I was given a nose clip which I guard with my life. I've had nothing cauterized, because they couldn't find anything to cauterize! I'm on a different anticoagulant now (not because of the nosebleeds), and I still get them, but far less often. They aren't as severe as before either.

It is very upsetting to get them, and horrible to get the bad ones. I had a 45-minute one a few days ago and it affects me into the next day, just the stress of it.

Look for a nose clip I would say, and keep looking for an answer! Good luck.