Meds to avoid

I am new to the diagnosis on vWD type 1 and never realized (nor paid attention to) OTCs or prescriptions that cause bleeding issues. I just found out that, aside from NSAIDS, that some muscle rubs and even pepto bismol suspension can cause bleeding trouble. Does anyone have a list of meds to avoid other than NSAIDS (Ibuprofen, Aleve, Advil)?

Be sure to always ask everybody that gives you over the counter or prescribed meds - do they cause blood thinning such as aspirin?

thanks! The book 100 questions & answers about von Willebrand Disease by Andra H. James has a list of a bunch to avoid!!

I like the way John has worded that “will this cause blood thinning”. Always best to not use terms that can confuse people, like vWD!

Drugs that can cause bleeding

People with bleeding disorders should avoid aspirin and other drugs that can cause bleeding. This list of drugs that can cause bleeding does not include drugs that have to be given as injections or intravenous infusions. The generic or “chemical” names are given since the brand names or marketing names differ between countries.

While every effort has been made to include as many drugs as possible, some may be missing. In addition, many non-prescription medications, such as cold remedies, contain aspirin. People with bleeding disorders should check with their hemophilia centre or physician, or consult the pharmaceutical company’s printed instructions before taking any new medication.



Acetylsalicylic acid (Aspirin)

























*These antidepressants have a mild inhibiting effect on the platelet function, which may increase the bleeding tendency. However, since they are less harmful than most other antidepressants in other respects, it is possible to try the medication by starting at a low dose and carefully increase it. Many patients will tolerate these drugs.

Herbal drugs (phytomedicines) that can cause bleeding

While every effort has been made to include as many herbal drugs as possible, some may be missing. Some herbal medicines have been reported in association with bleeding, but in these cases the patient also took regular drugs that could have caused the bleeding or that the documentation in other respects was weak. These have not been included in this list.

People with bleeding disorders should check with their hemophilia centre or physician, or consult the pharmaceutical company’s printed instructions before taking any new herbal drug.

Ginkgo biloba

Garlic in large amounts

Ginger (not dried ginger)

Ginseng (Asian)


Saw Palmetto (Serenoa repens)

Willow bark

Prepared by Sam Schulman, MD

Posted: January 2006

Hello to all,

I would like to add to the med list post, a little about my experience, from a proactive patient point of view. When you visit an ER, Hospital or Doctor's office they will ask you about allergies. Tell them upfront and firmly, to list Heparin , aka coumadin/warfarin, and NSAIDS, as major allergies. Also have them note on your record that you have a Hemophilia-like coagulation disorder. Most staff, even the MDs have little, if any experience with vWD using its real name. Coagulation disorder or Hemophilia-like condition, is much more informative.

Intravenous infusions require your extra vigilance. After an infusion or transfusion, the IV tech will rinse the line with a 10 mL syringe of Heparin solution. This is to prevent a clot developing at the end of the needle/cannula in your vein. Putting Heparin in your system is dangerous. 99.9% of IV patients can tolerate the Heparin, you can't. The Heparin rinse syringes have a yellow tip. In your case, a 10 mL syringe of normal saline is standard procedure. Always, Always, Always, remind the nurse not to rinse the IV with the yellow syringe. They don't remember all the time because they don't see bleeders very often. Yell "Lawyer", if you get a stubborn nurse who doesn't listen. That word perks up their ears. Trust me it happens, especially close to shift change time.

Next time the Cymbalta add airs on TV, watch closely for the little disclaimer that it might add to bleeding problems. It almost did me in with GI bleeds. Cymbalta, and other SSRI/SNRI medicines affect seretonin in the blood. Seretonin is part of the chemistry of the coagulation cascade. Just about all SNRI/SSRI drugs have this effect. There are some older anti-depressants that don't interfere with coagulation. Discuss this with your Doctor.

Good luck with your medical community!

John the elder

There are lots to avoid. Of course aspirin, NSAIDS, etc. But you have to be careful with other "natural" ingredients. For example, my family doc had me take melatonin for insomnia. Well, I started having blazing nosebleeds daily. So I quit. My oldest son (stepson) started using the melatonin and he began having nosebleeds, even though he doesn't have a bleeding disorder. So beware the melatonin. Also I just try to avoid all but the most know and safe herbal meds. Especially if you have HCV and vWB, because there are many products that can harm the liver and/or the bleeding cascade. Just because it says "natural" doesn't mean it can't really mess you up!