Aspirin bleeding problems

[Grendall]

hi everyone,

Just wanted to get a little feedback if possible.

I had an issue about 10/12 weeks ago where I had a bleed from my back passage (already posted about this) went to hospital had all blood tests etc done and all appeared ok but was tol to stop aspirin for time being

Had appointment last week and it was mentioned as was on my notes, doc asked if I had been ok (yes) so to restart aspirin. Have done so and within a couple of days getting blood through my nose again I also have bad reflux with it so have to take lanzoprazole alongside, i do believe that the aspiring doesn’t suit me and causes internal bleeding (hence from back passage) I feel it is affecting my gastrointestinal area which would have caused the bleeding then.

The other thing I have noticed over the last couple of months (although not been taking aspirin) is I have a kind of faint blotchy rash either side of me nose/cheeks. I’ve never had anything like this on my face before and the other day when I started taking aspirin again I got a specific red blotch like a spot but it isnt.

I can’t decide or make sense as to whether this blotchyness on my face is from my ET or the aspirin! X

[Mazcd Partner MPNVoice]

hi Grendall, so sorry to hear that you are experiencing this, not very nice for you. You should discuss this with your haematologist, about having an alternative to Aspirin, for instance Clopidogrel. I hope you get this sorted out soon. Best wishes. Maz

[ainslie]

As Maz has said you should discuss this with Haem asap, stopping aspirin and not replacing it with something else when you need it for your MPN could be risky thrombotic risk wise

[saltmarsh]

I had a bleeding issue a couple of times as well as stomach issues. In each case I stopped the aspirin for a couple of days and then resumed every other day for awhile and then back to daily. My former hematologist indicated I could cut back even further. But who knows?

In the end I concluded that my daily glass of whiskey was the root cause of both problems. As much as I missed the evening cocktail, it was the right decision. For me.

Good luck with finding the solution. I know this is not pleasant to be dealing with but I'm confident you'll find a good solution. Best wishes

[Batman66]

I did have bleeding issues with dispersable aspirin, but changed to enteric coated which seems to have worked for me. Best you consult with your doctor. Good Luck.

[Amethist]

With the agreement of my MPN specialist, I just take ½ a regular aspirin every third day. I’ve had no previous clotting issues but I do have high platelets so more at risk if haemorrhage than a clot . I was concerned with how easily I bruised and wondered what was happening on the inside, where I couldn’t see. 🫤

Probably safer alternatives out there which would suit you better. Make an appointment sooner rather than later.

[Anag]

aspirin is not always safe. Even if it is battered and protect your stomach it then causes problems further down in your intestines. If you are bleeding, you are definitely taking too much aspirin or you have other problems. It’s a very good idea to have a gastroscopy and colonoscopy to make sure your digestive tract is working well, and that there are no complications. It doesn’t sound good to be bleeding from the backside for any reason. Perhaps it is just haemorrhoids.

Please make sure if the doctors are checking the viscosity of your blood to make sure if you need the aspirin or not. An MPN specialist is always the way to go! Most haematologist are very weak in treating us. Because I was having bleedings, where are my nose is running almost like a faucet, I reduced my aspirin from 100 mg to 50 mg every third day and take ginkgo in between, that is 120 mg in the morning and 120 mg at night to have 24 hour coverage. The Aspen gives me basic coverage and if I get bleeding or bruising, I just stop the ginkgo and it’s out of my system by 9 to 12 hours. Aspirin stays in the body up to 10 days, getting weaker as the days pass, of course.

I really check my body closely so I can know what it’s doing. I can’t trust any Doctor Who is completely overburdened these days to really keep it proper tab on my Health! It is so important for us to be teamed up with our doctors in order to have the best possible treatment. 😃

hope to have helped all the best. Anag

[FG251]

If you switch to Clopidogrel (as I did), note that Omeprazole is contraindicated. You’ll need to continue Lansoprazole. I tried stopping the latter and got horrible heartburn.

[havashan]

I had nose bleeds taking 1 baby aspirin every day. So my MPN specialist told me to reduce it to 1 aspirin Monday, Wednesday, Friday. I have no problems with this regime.

[Mishie14]

The short version is I had pain and great intestinal discomfort after taking tablet 84 aspirin. It was on advise of cardio doctor to try a liquid capsule version called Vazelore. It's the same dose but in a different form that doesn't sit in stomach to dissolve. Intestinal issues stopped and have not returned.

The longer version is at that same time I was also taking Clopidogrel that I proved conflicted with Omeprazole that had been prescribed to address repeating heartburn. Was told to take them a minimum of 2 hours apart but that did not address heartburn issue. Cardio doctor stopped the Clopidogrel, saying it was not good to take it for more than one year. Stayed on Omeprazole a very short time but then I stopped taking it when I switched to capsule aspirin. The drug conflict is real but the root cause for me was the tablet aspirin.

Good luck in your journey and stay safe!

[PhysAssist in reply to Mishie14]

Hi Mishie14,

I'm glad to see that you found a stable way to keep from thrombosis.

While you are absolutely right about the Omeprazole [Prilosec] contraindication with Clopidogrel [Plavix]-:

Co-administration with proton pump inhibitors (PPIs) may reduce the cardioprotective effects of clopidogrel. The proposed mechanism is PPI inhibition of the CYP450 2C19-mediated metabolic bio-activation of clopidogrel.

from: The Drugs.com Interaction Checker,

The citation goes on to say that ALL PPI's [proton pump inhibitors] have almost the same likelihood of interacting and that the risk of cardiovascular events:

"Specifically, use of a PPI was associated with a 70% increase in the risk of heart attack or unstable angina, a 48% increase in the risk of stroke or stroke-like symptoms, and a 35% increase in the need for a repeat coronary procedure. The event rates for the individual PPIs are esomeprazole 24.9%, lansoprazole 24.3%, omeprazole 25.1%, and pantoprazole 29.2%, compared to 17.9% for the no-PPI control group."

They did not find that taking H2 blockers with clopidogrel [cimetidine, famotidine as e.g.] had any increased risk of untoward events.

Finally, it's not clear why a cardio MD would say that taking Plavix for > a year was "not good", but they must have been concerned about an individual issue rather than a generalization, because I have seen some of both my patients and my family members, who are/were taking it with an MD's statement that they would need to be on it in perpetuity.

Just saying,

PA

[Mishie14 in reply to PhysAssist]

Thank you very much for this additional information! Continuous learning about living with MPN is appreciated. Please stay safe!

[PhysAssist in reply to Mishie14]

Hi Mishie14,

You're so very welcome!

You as well!

PA