None bleeds

[Youelbeverly]

Has anyone on Rituximab and methotrexate experienced nose bleeds

I'm trying to figure out if its related to the meds.

[Neonkittie17]

No, not in over 15 years of Mtx and not in 8 years of Rtx which has been combined with Mtx. We all react differently though. (I don’t have many phobias but nosebleeds is one. 😑) I hope this settles for you. Have you been on these meds for some time or just started Rtx? I’d report it to your rheumy nurse. Just so they are aware. Good luck.

[Youelbeverly in reply to Neonkittie17]

I've been on them for 18 months and 1 year. I appreciate the long term feed back.

[Neonkittie17 in reply to Youelbeverly]

Hi, Just asked to see if you were new to Rtx but that’s not the case. I hope you can sort this out. 🙏🏻

[julie1908]

Are you taking any blood thinners at all?

[Youelbeverly in reply to julie1908]

Occasionally 81mg aspirin when I can remember.

[AgedCrone]

No & I’m susceptible to nose bleeds.Have been on Rtx for 6 years & had no more bleeds than usual.But do mention your experience to your rheumy team 

[Youelbeverly in reply to AgedCrone]

Thank you. All this is very helpful. When you have numerous issues you kinda have to weed through the overlapping possible causes.

[nomoreheels]

Hiya Youelbeverly, welcome. I'm not on rituximab but have been on MTX 13 years & not had a nosebleed in that time. In fact I don't think I've had one since childhood.

How have your bloods been? It could be an indication your platelets are low.

I’d ask your Rheumy, see what he/she makes of it, though it seems odd if they're a recent thing as you're not new to either med. Still, worth asking.

[Youelbeverly in reply to nomoreheels]

Good thought. I just had labs so I will check. I'd never had a nose bleed in My life prior to the past few months. Thanks 😊

[Annpisan]

I'm not on Rituximab, but I know that my Mtx causes both mouth sores AND nasal sores. Mtx interrupts fast growing tissues such as mucous membranes found inside the nose. I upped my Folic Acid to 5mg every day except Mtx day, and the sores have resolved. Sores in the nose can easily bleed spontaneously. Just a thought.

[OldTed60]

I had same concern some years ago when on MTX and I started having nasal sores and heavy bleeds having never had these before. It turned out that I was suffering from Sjogren's as well as RA and now, Scleroderma. The dryness when it was cold and heating was on was the cause and still is - only now I rarely put the heating on due to the cost and although my Raynaud's is getting worse I've not started getting nose bleeds again yet. Each ENT has scoped and has said it's Sjogren's related burst capillaries. Sjogren's is a common bedfellow autoimmune to RA and other rarer autoimmune diseases so worth considering perhaps?

[oldtimer2]

If the nose bleeds are minor then they are probably due to dryness of the lining of the nose exposing the samll blood vessels which then become easily damaged by nose blowing etc. Using cream in your nose and hydrating your nose (saline nose drops or spray) helps with that.

If the nose bleeds are large, then it can be a sign that your blood is affected and you should have a blood test to check that your medication is not casuing problems.

[Leics]

Luckily I’ve never had a nose bleed in my life either. I’m inclined to think it’s the aspirin you’re taking (when you remember) in combination with other meds that may be the cause. That’s presuming that you’re having blood tests as a follow up for Rtx. If it becomes a problem on a regular basis I would have a review with whoever prescribed the aspirin as if it was your GP are they aware of your rheumatology meds ? Sometimes one healthcare department doesn’t always speak to another so worth a chat. Hoping they subside very soon though because it can’t be nice. On the other hand my husband gets nose bleeds all the time doesn’t have AI disease and doesn’t take any meds so who knows ?