Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
When these two medicines are taken together, your pain medicine may increase the effects of heparin.
What might happen:
You may experience an increased chance for bleeding including bleeding from your gums, nosebleeds, unusual bruising, or dark stools.
What you should do about this interaction:
Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these two medicines together. They may already be aware of this interaction and may be monitoring you for it. If your doctor prescribes these medicines together, it may be necessary to check your bleeding times more often. Do not start, stop, or change your dosage of any medicine before checking with them first.
1.Weiss HJ, Aledort LM, Kochwa S. The effect of salicylates on the hemostatic properties of platelets in man. J Clin Invest 1968 Sep; 47(9):2169-80.
2.Zucker MB, Peterson J. Effect of acetylsalicylic acid, other nonsteroidal anti-inflammatory agents, and dipyridamole on human blood platelets. J Lab Clin Med 1970 Jul;76(1):66-75.
3.Niklasson PM, Blomback M, Lundbergh P, Strandell T. Thrombocytopenia and bleeding complications in severe cases of meningococcal infection treated with heparin, dextran 70 and chlorpromazine. Scand J Infect Dis 1972; 4(3):183-91.
4.Schondorf TH, Hey D. Combined administration of low dose heparin and aspirin as prophylaxis of deep vein thrombosis after hip joint surgery. Haemostasis 1976;5(4):250-7.
5.Rubenstein JJ. Letter: Aspirin, heparin and hemorrhage. N Engl J Med 1976 May 13;294(20):1122-3.
6.Yett HS, Skillman JJ, Salzman EW. The hazards of aspirin plus heparin. N Engl J Med 1978 May 11;298(19):1092.
7.Jick H, Porter J. Drug-induced gastrointestinal bleeding. Report from the Boston Collaborative Drug Surveillance Program, Boston University Medical Center. Lancet 1978 Jul 8;2(8080):87-9.
8.Walker AM, Jick H. Predictors of bleeding during heparin therapy. JAMA 1980 Sep 12;244(11):1209-12.
9.Heiden D, Rodvien R, Mielke CH. Heparin bleeding, platelet dysfunction, and aspirin. JAMA 1981 Jul 24-31;246(4):330-1.
10.Theroux P, Ouimet H, McCans J, Latour JG, Joly P, Levy G, Pelletier E, Juneau M, Stasiak J, deGuise P, et al. Aspirin, heparin, or both to treat acute unstable angina. N Engl J Med 1988 Oct 27;319(17):1105-11.