Fragmin and aspirin

[Bigcheat]

Hi again,

Injured myself, like I wrote below, and have therefore been shooting 5000 IU of Fragmin every day, and not sure when I am allowed to quit it.

I am writing this post since I am a bit unsure whether I should put baby aspirin on hold or not, or halve the dose. Been receiving mixed advise from two doctors.

Had nose bleeds on days 3,4,and 5 but not for a couple of days now. Should I be asking for some bloodtests to find out that it is safe to continue without risk of internal bleeding?

Br,

Bigcheat

P.S. Going to know on Monday whether I need a surgery on the knee.

[Mazcd Partner MPNVoice]

hi Bigcheat, the doctor who prescribed the Fragmin will advise you about when you should stop it, and should also advise you about the aspirin, I note that you have had mixed advice from 2 doctors, so maybe speak to your haematologist about it for advice. Best wishes, Maz

[hunter5582]

As you have already surmised, there is a drug interaction between Fragmin and aspirin. The warning from ePocrates advises:

Monitor/Modify Tx - Fragmin (dalteparin) + Low Dose Aspirin (aspirin) monitor bleeding s/sx: combo may incr. risk of GI or other bleeding, incl. life-threatening (additive effects). online.epocrates.com/intera...

In the presence of a MPN, this sort of interaction needs to be monitored closely and treatment modified as needed. Suggest you consult with your MPN Specialist on this issue. Other specialists are unlikely to be familiar with your treatment needs having a MPN and being on aspirin. Note, that when I was on Heparin following surgery, the docs did discontinue the aspirin.

True story - I went to see an excellent orthopedist regarding a knee injury. He asked me "What is Polycythemia Vera? It has been a long time since I was in medical school." Note that this doc is a great doc who is very skilled - in orthopedics. Suggest asking your question about the aspirin-Fragmin interaction with a doc who is very skilled - in MPNs.

The repeat nosebleeds are concerning and should be followed up as an emergent issue. Suggest an urgent call to your MPN Care Team.

Hope you get it all resolved ASAP.

[Wyebird]

if you are seeing a doctor on Monday maybe ask for advise.