Managing Minor Bleeding on Blood Thinners

Anticoagulants (blood thinners) are lifesaving medications for people with atrial fibrillation (AFib) or a history of blood clots. They are also widely used to prevent clots in hospitalized patients and those undergoing surgery. Like all medications, anticoagulants can cause side effects. The most serious is life-threatening bleeding, such as a brain hemorrhage. But in most cases, bleeding episodes are minor and manageable at home.

What Is Minor (Non-Life-Threatening) Bleeding?

Minor bleeding refers to small bleeding events that are bothersome but usually not dangerous. Examples include:

• Nosebleeds

• Bleeding gums

• Easy bruising

• Cuts that take longer to stop bleeding

While these symptoms can be frustrating, they usually do not require emergency care. Still, many people go to the emergency room for minor bleeding—leading to unnecessary interruptions in blood thinner therapy. According to the Michigan Anticoagulation Quality Improvement Initiative (MAQI):

“Patients rarely contact a provider about minor bleeding before going to the emergency room… and minor bleeds can prompt patients to stop anticoagulant therapy, even though guidelines support continued anticoagulation.”

Stopping blood thinners without medical guidance is dangerous. Doing so can lead to:

• Deep vein thrombosis (DVT) – blood clots in the legs

• Pulmonary embolism (PE) – blood clots in the lungs

• Heart attack or stroke

“All of these conditions can be fatal, which is why patients should never stop their anticoagulant medication without speaking to their clinician,” says Dr. Melissa Pynnonen, a Professor of Otolaryngology and Medical Director at University of Michigan, who specializes in bleeding management.

How to Prevent and Manage Minor Bleeding

If you take an anticoagulant, you can reduce the risk of minor bleeding with simple steps:

1. Prevent Nosebleeds

• Use a humidifier to keep indoor air moist.

• Apply nasal saline spray to hydrate nasal passages.

• Avoid forceful nose blowing.

• If a nosebleed happens, pinch your nostrils and lean slightly forward (not back) to avoid swallowing blood.

2. Reduce Gum Bleeding

• Use a soft-bristled toothbrush and floss gently.

• Avoid alcohol-based mouthwash, which can dry out gums

• See your dentist regularly for preventive care.

3. Prevent Excessive Bruising

• Be cautious with physical activity—wear protective gear if needed.

• Avoid high-impact sports that increase risk of falls or injuries.

• Check with your clinician before taking aspirin or NSAIDs (like ibuprofen), which can raise bleeding risk.

4. Manage Minor Cuts and Scrapes

• Apply firm pressure with a clean cloth for several minutes.

• Use a cold compress to help slow bleeding.

• Keep bandages and antiseptic ointment on hand for quick care.

When to Seek Medical Attention

Most minor bleeding can be managed at home, but serious bleeding needs immediate care. Call 911 or go to the ER if you experience:

• Bleeding that doesn’t stop after 10 minutes of pressure

• Blood in urine or stools (red or black/tarry stools)

• Frequent, heavy nosebleeds that don’t stop after pressure

• Coughing or vomiting blood

• Severe headaches, dizziness, or weakness (possible signs of internal bleeding)

If you’re not sure whether bleeding is serious, call your clinician for advice.

Final Thoughts

Minor bleeding is common for people on blood thinners, but it is usually manageable with a few precautions. Most importantly, do not stop your anticoagulant without medical guidance, as this can raise your risk of dangerous blood clots. If you have concerns, talk to your clinician about safe ways to manage bleeding.