Hi all
Just recently I've started to get quite a few nosebleeds, some quite bad some not so. But in the last week I've had 4 or 5 I suppose which isn't normal.
I had a HA in December and been on various meds (Atorvastatin 80mg, Clopidogrel 75mg, Lansoprazole 30mg, Ramipril 2.5mg, Riveraxaban 20mg).
Wondered if anyone had the same thing or some info on why these bleeds have started?
Cheers
Hello 
I was on Ticagrelor which is a blood thinner I had very bad nose bleeds and ended up while I was on it having to have my nose cauterised 3 times since coming of it I seem to be doing alright
You need to speak with your Doctor it could be one of the meds but they should be able to see what is happening up your nose and get it sorted
Good Luck and let us know how you get on x
Thanks BeKind-28 - I'll do that. However, it'll probably be 2 weeks before I can speak to any doctor knowing my GP surgery 
Hello
Tell them it is a emergency you cannot wait that long not that it may work but you can try
I know how unpleasant and difficult nose bleeds are to cope with even though some just think it is a nose bleed one of mine was that bad that I ended up at A&E and by the time I got there I think they thought I had been in an accident I was covered in blood !
I hope you manage to get it sorted soon we have a nose Doctor not sure what his title is but that is what I call him he cauterised my nose 3 times maybe you could ask if you have one ?
Everything and anything is worth trying I always think when we need to hope you will get it sorted soon and again let us know x
contacting your doctor. I have taken to putting my question in full detail in a letter and handing it in by hand at the surgery. So far has resulted in a call back same day. The receptionists hate this as they have to then manually type it in to their system - but if no other way !!! PH
Hello
Never thought of doing that but sounds like it works something maybe a few of us could try
Thank you for letting us know x
I use the NHS app. There’s a messaging function which allows you to contact the surgery you are registered to during surgery hours. This seems to work well for me.
Hello
That sounds good I struggle with apps though if I am honest
I am quite lucky though as my Doctors contacts me twice a week and in between if I need her I just have to phone up and ask them to send her a task and she will phone x
now that’s a service! You are very lucky.
I called my doctors this morning, got the receptionist, and she said fill out an E-consult form. I should get done feedback by the end of tomorrow 😢
Hello
Yes I agree certainly a very good service and wait for it she chats up to an hour with me each time to
I am grateful though for that
I hope you get a good feedback tomorrow x
I fill out the e consult form, although they’re a nuisance, all the daft questions, but my Doctor usually contacts me in a couple of hours by sending me a link of loads of appointments I can choose from. Much better than speaking to receptionist who tells me to call back in the morning at a certain time, then I can’t get through.
thanks Deejay62, unfortunately, and predictably for my useless doctor’s practice, they haven’t bothered replying to my E-consult form that I submitted yesterday morning. This is after speaking to the receptionist who said it would be quicker 🤣.
I’ve clicked the link to say I’ve had no response. I wonder how long it’s going to take to get a response!?
Luckily I’ve had no nose bleeds in the last 2 days which is encouraging 👍
I use our GP surgery webpage to contact my GP - send him a note and he replies!
hi
I started getting frequent nose bleeds last year, unrelated to medications, followed having a cold. GP referred me to community ENT where helpful folks cauterised my nose, after 4 attempts ,over several months, with silver nitrate and still getting bleeds referred for electronic cauterisation. Which is a day case. During the wait bleeds stopped, so fingers crossed all ok now.
Hi yeah I have aswell but I figured it's just the cold weather my nose hardly ever bleeds and when it does I can't help but worry. Just keep an eye on it 👁️😉. I definitely am 😅. Have you told your cardiologist? or GP.
Thanks for the reply. No, not spoken to either yet. Wanted to see what feedback I got here first.
I think I will try and contact the doctors and see what they say. Might be quicker to contact my cardiologist nurse though!
Yeah I recommend contacting your cardiologist nurse first.
I frequently gets daily nosebleeds in winter and obviously these are now worse since I've been on blood thinners for AF. Don't assume that cautery is always the most appropriate first line response. Nasal infections are frequently the culprit behind recurring nosebleeds (at least they are in my case).
It may be worth asking your GP if a course of Nasonex cream might help. It's very easy to use, but it needs to be applied according to instructions and probably for 10 days to be effective. I believe it can also be prescribed for use as a precautionary measure too. Again, you'd need to speak to your GP.
Difficult to gauge the amount of bleeding you are a having but they are obviously now quite frequent. If you feel faint or dizzy or if the bleeding continues for 30 minutes or more you should treat it as needing urgent attention.
I have had nosebleeds over two different periods. The first time it was treated by my local GP with silver nitrate and this was successful for about 10 years. When they recurred they were more severe and more frequent. The new GP then tried treatment with Naseptin cream. This helped but the nosebleeds came back a short while after the treatment stopped.
I was then referred to an ENT consultant. She cauterised the offending area. Not a pleasant experience, I felt as though I’d had a few rounds with Muhammad Ali, but it was very effective. I haven’t been troubled since.
I hope you get it sorted soon as I know how unpleasant it can be.
Thanks!
I will be on the phone this morning. I had the worst bleed last night. Just wouldn’t stop. Must have been an hour or so.
Sorry to hear that. I know its really hard at the moment but did you speak to someone about that yesterday. It's a long time for a nosebleed. A&E Dr said 20-30 mins then get medical help
No didn’t fancy calling anyone on a Sunday night tbh
Will do this morning 👍
It may be the medication. I have had two 12 month spells on Ticagrelor antiplatelet following HA and Angiogram. Each time I suffered with nosebleeds, the first time was towards the end of the spell so after cauterisation the Ticagrelor was stopped and all fine. The second spell I started to have nose bleeds and would wake each morning with blood in my mouth. I spoke to GP and we halved the dose which reduced the bleeding. I have since completed the spell on Ticagrelor and the bleeding has stopped. Just the daily 75mg of aspirin is tolerated well. Suggest that you insist on an appointment with your GP. Having an uncontrollable nosebleed is not a pleasant experience and neither is the trip to A&E or the treatment!
Following this as my son gets frequent nose bleeds and we have ENT appointments at the end of the month. He is not on any meds as his condition has been classed as mild. But I have often wondered if there is a connection? My son has HCM and aortic root dilatation.
Will let you know what the doc or cardiac nurse say Livelivelife56 👍
Did I see that you take Clopidogrel and Rivaroxaban? Check with your pharmacist, or clinical pharmacist, that you need both, as I was originally on Clopidogrel but was changed to Rivaroxaban, but was told to leave 24hrs between the two.
yes I’m on both.
Consequence of having a LVT clot post HA I would assume. I’ve got a scan next month to hopefully confirm that has gone. Maybe the meds will be toned down after that 🤞
I had a similar experience a few weeks ago. I had a HA in October and am on similar meds to you and a few weeks ago was having 2-3 heavy nosebleeds a day. I went to my GP who prescribed Naseptin and said to go to A&E if they last longer than 15 minutes. I also had to have bloods to check my platelets. After a few days the nosebleeds stopped and my blood results came back normal. I have not had any more since.
I suffer from posterior nosebleeds so cauterisation doesn’t work ( - although A&E insist on trying this each time I turn up despite my previous history !)
Like others it’s cold weather, combined with indoor heating that triggers it, aggravated by the blood thinners. Now using a humidifier at night, saline spray regularly and vasaline up the nose before venturing outside if it’s below 4 degrees.
When I’m in a series of bleeds they can start at any point, last anything up to a few hours and cause constant panic attacks. The impact is not to be underestimated and is very restrictive - not driving, not leaving house, not socialising ….
ENT blame blood thinners but cardio insist I remain on them - hoping to reduce / stop them post ablation
agree on the restrictiveness. I’m having second thoughts about going into work today as an hours nosebleed at any time would not be good.
I’m trying to call through to docs but it’s just going to engaged tone after the recorded message. They aren’t very good it must be said.
Unfortunately, if you are prone to getting nose bleeds then an anticoagulant will increase the chances. I’ve had nose bleeds all my life due to injuries from rugby etc, some bleeds have lasted hours. However, now that I am on Riveraxaban for AF, I take my bleeds seriously and turn up at AE and explain. In addition I always carry the card from inside the medication in case I’m involved in an accident.
thanks. The thought of spending hours and hours in A&E fills me with dread!
But I’m getting nowhere with my doctors recorded message and then engaged tone!
Had an hours worth of bleeding last night so seems to be getting worse.
What a pain
Cheers
for thé first 12 months after my HA I was on clopidogrel 75mg and riveroxaban 15mg. my riveroxaban was only increased to 20mg once i stopped the clopidogrel.
Morning. Whjlst on ticagralor after my heart attack i had horrendous nose bleeds which lasted well over an hour with a few a+e visits. The clopidigrel is most likely the offending culprit. On the bright side it shows its working by preventing clots....😜Jules x
l had nosebleeds, quite bad, a few years ago and had to have my nose cauterised three times and since then no problems., They became so bad they were taking over my life and became scary. My doctor said not to worry, but easier said than done. It was just one side of my nose. The doctor will sort you out.
thanks, I should hear from doctor by end of day tomorrow but a few on here have advised to contact my cardiac nurse so will do that tomorrow morning as well and see what she says
My partner has clopidogel after a stroke then riveroxiban after DVT and PE. He then begun to get loads of bruises and several nose bleeds. As both med have a blood thinning element but by different mechanisms when he he was later in hospital with another problem shortly afterwards, I queried whether both were necessary and the clopiderol was discontinued as it had failed to prevent the DVTs etc
Hi Eagle69I had this too, more of haemorrhage than nose bleeds I went to A&E, they eventually put a Nadal plug in place, kept me in overnight, layer the next day the ent vonsultant came around, deflater the nasal plug, an hour later the bleeding hadn't restarted so he removed it, and cauterised 3 arteries, which was fine, a few weeks later it started again, I got to see my gp, who recauterised them, and haven't had any since.
Trish
I have taken Aspirin and Ramipril for many years without ever having any nasal bleeding, then a couple of years ago added Atorvastatin to my daily drugs and about a week after starting this had two massive nosebleeds which hospitalised me for 4 days. They were rear nasal bleeds which cannot be cauterised, and the packing that was used to stop the bleeding is very unpleasant. I immediately stopped taking the statin and have had no bleeding since. I note that nasal bleeding is one of the ten most common side effects of Atorvastatin. I now use alternative methods of lowering cholesterol.
There is a very important distinction between frontal nose bleeds, which can usually be readily cauterised, and rear bleeds which occur above the soft palette and usually arise from arterial branches. The latter cannot be easily treated and I feel are very serious.
I can sympathise with you.they are the most horrendous things but not life threatening. I had 2 huge ones last year.ended up in hospital for 5 days had a rapid rhino and had it cauterised. Whatever you do no hot showers of drinks and no heavy lifting.blood thinners make it a whole lot worse.rest up till they ease off no bending over either.good luck with getting better.i had 2 2 years ago and 5 stents still have problems eating and walking get pain in back if I eat touch then exercise.good luck.
A rapid rhino sounds horrendous! Thanks for the feedback
I am going to say it is almost definetely the blood thinners and I would ask my GP or cardiologist why I need to be on both Rivarobaxan and Clopidegrel at the same time. They are both strong antiplatlet drugs so you need to ask this question. You can get a lot of info on interaction checker on a website called drugs.com. Do not change your medication unless told so by a professional.
Get them to reveiw your meds. I started with nosebleeds and before I knew it I was in hospital with Anemia and low iron. It was Riveroxaban that triggered it. As a female I bled continously on my periods as well. Advice for any females in that situation....get the coil fitted!
Sceptico has already mentioned Atorvastatin as a possible cause and I notice you are on the maximum dose of 80mg. Just to ram that point home, here is a quotation from the Atorvastatin information sheet: Other possible side effects with Atorvastatin
Common: may affect up to 1 in 10 people
inflammation of the nasal passages, pain in the throat, nose bleed.
I am on warfarin and at the time of my nosebleed, I was also on aspirin and Atorvastatin. I ended up having two hospital stays of 4 days and 5 days and on the first stay, after cauterisation failed, I had a spheno-paletine artery ligation (tying off) under general anaesthetic. If the later had failed through the nose, they warned that they would have to operate on my neck and ligate the artery where it joined the carotid artery and it would leave a permanent scar on the side of my neck.
These bleeds are serious and very uncomfortable to deal with so they must be taken seriously. I don't know if other statins have the same side effect as Atorvastatin, but if they are different I would suggest a switch to a different one or just come off them completely for a time or maybe even permanently given recent papers about them. The fact that one in 10 can be affected by what they state as a non-serious side effect seems to be hiding the truth to me. I think this is a serious side effect, but if they stated in the patient information leaflet that 1 in 10 could have a serious side effect, nobody would take it and sales of the world number one drug for profit in pharma companies would nosedive. Pun intended.
Nose cautery is the more permanent solution to nosebleeds. Other methods can work but you are guaranteed to have the same problem again. So basically go for cautery and keep your mind at rest and don't leave it hoping for the best - take it seriously.
I've been getting one or two a week for a while now. Some very light, others literally 2-3 drops per second and take a while to stop when "bunged up" with tissue.I think it's time of year in part. Dry air and central heating means the lining of your nose dries out and then capillaries crack.
Mine starts more often than not when I get in the shower, or roll over in the night. I imagine the hot water dilates capillaries and then they crack.
Being on blood thinners/daily aspirin just means they take much longer to stop.
I'd only be concerned if they cause a lot of blood loss or take more than 20min or so to stop. Worth asking the Doc though as I'm no medical expert.
Same…rolling over in bed has triggered it a couple of times as well as the cat head butting me 🤣
I have had a couple of bleeds that have lasted more than 30 mins.
clopidogrel. It’s a blood thinner. Was on both that and aspirin got nose bleeds and bruise at the slightest knock. If nose bleeds persist best to have a word with gp or consultant
I get nosebleeds I’m on warfarin. Usually it’s when my blood level is high (INR). I can’t remember what the long winded name is. It’s blood clotting level. Most of the time it happens when I bend my head.
Hi i had nose bleeds all the time as a child they then eased back and eventually stopped i would get the odd one usually whenever I'd get a cold. In 2019 i had a mild heart attack and a stent fitted came out of hospital the a cocktail of medication some for a year some for the rest of my life Clopidogrel was one of them which was for a year when on this i had nosebleeds every day but after a year it was stopped then within a couple of weeks my nose bleeds stopped . hope this helps
Yes interesting Simon. Clopidogrel has been mentioned a few times by others. I may need to live with it for a while (still waiting to hear from my GP 😤)
Thanks for the reply
Quick update is that there is no update!
As I said previously my doctors are useless. I raised an e-consult request on Monday morning. Should have had a call back by 6:30pm Tuesday, that never happened. I even clicked the no reply link and they still didn’t contact me today so I spent an hour or so waiting on the phone to speak to someone.
Eventually got through and, long story short, was told by a receptionist that I should go to A&E as my bleeds were over 15 mins! I’m not doing that. They also said it can take 5 working days for someone to respond to an e-consult request! I literally can not believe how bad my practice is! Awful.
Will be calling my cardiac nurse tomorrow and maybe should have done that earlier.
In the meantime I didn’t have any nose bleeds Monday or Tuesday but had one this morning which lasted 20 mins or so sadly.
sores in nose 
Surgery scar
Hello, 
Apixaban and Antidote for bleeds.
Slightly concerning 
