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Have blood clot in lung after total knee replacement. On Warfarin. Have nose bleeds. Suggest

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General & Family Physician
Practicing since : 1978
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I am on Warfarin-4mg perday -blood clott in my lung after Total Knee replacement -Oct/11- for the last 4
days I have 3-4nosebleeds a day-had one this morning-early- I blew my nose very gently and a fairly large
clot came out- and it is now 14 hrs since the last nosebleed- was this clot maybe causin the nosebleeds?
Posted Fri, 19 Jul 2013 in Blood Disorders
Answered by Dr. Pavan Kumar Gupta 2 hours later
Thanks for the query.

Nose bleeds are very common occurrence and can occur due to various causes like nose picking, nasal allergy, use of smoking, cocaine and alcohol etc.
But there are all the chances for bleeding to occur, if you are on anti-coagulant therapy like warfarin.
This occurs due to increase in international normalised ratio (INR) .
Nasal bleeding can also occur if a person is taking aspirin, CLOPIDEGROL, high dose of VIT E or high amount of garlic or even natural products like ginkgo biloba.

Since it is already 14 hours from your last bleed, it looks to be from nasal trauma only.
However, if bleeding recurs, then you should go to ER and get INR checked.
If high,then anti coagulant therapy has to be stopped and VIT K given.
However don't take VIT K of your own.

I hope it helps however you may revert to me for any further query.
best of luck
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