People who take blood thinners have double the risk for dangerous internal bleeding if they also take non-steroidal anti-inflammatory drugs (NSAID) like ibuprofen, diclofenac or naproxen, according to a Danish study published in the European Heart Journal. The increased bleeding risk was not limited to the digestive tract, but also affected other organ systems such as brain, lungs and bladder.
Researchers analysed data from 51,794 patients who were prescribed a blood thinner to treat blood clots in the legs or lungs. Overall, the risk of a bleed was 2.09 times higher when people took an NSAID and a blood thinner, compared with just taking a blood thinner. The risk was 1.79 times higher for ibuprofen, 3.3 times higher for diclofenac and 4.1 times higher for naproxen.
As for specific organ systems, the risk of a bleed in the gut when an NSAID was used with a blood thinner was 2.24 times higher. The risk of a bleed in the brain was 3.22 times higher; in the lungs,1.36 times higher; and in the urinary tract, 1.57 times higher.
The combination of the two medications also tripled the risk of anaemia caused by bleeding. A similar pattern of risk was seen across several types of blood thinners, including rivaroxaban, apixaban, dabigatran, edoxaban and warfarin.
“For people taking blood thinners for blood clots in their legs or lungs, our research highlights the importance of being cautious when considering NSAIDs for pain or inflammation. We recommend that patients consult their doctor before taking NSAIDs along with a blood thinner,” the study said.
