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I am trying to find an nsaid either otc or prescription that…

Customer Question
I am trying to...

I am trying to find an nsaid either otc or prescription that has the least effect on blood thinning. I have spinal stenosis that I need to take something for to keep the pain manageable and have taken naproxen, ibuprofen, meloxicam and diclofinac. They all thin my blood so much that I have ugly bruises on my hands and lower arms from very slight bumps in the course of my daily household duties. I fear that if i were to have a bad fall, or be in any kind of accident, I could have serious internal bleeding. i am 70 years old and otherwise healthy.

Doctor's Assistant: What medications do you take daily? Are you allergic to any medications?

No, I am not allergic to anything. I take eye vitamins, calcium + D, and antacids to counteract GERD from the nsaids and a fiber pill to counteract constipation from them as well.

Submitted: 3 months ago.Category: Medical
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Answered in 12 minutes by:
4/2/2018
Doctor: Dr. Greg, Board Certified MD replied 3 months ago
Dr. Greg
Dr. Greg, Board Certified MD
Category: Medical
Satisfied Customers: 770
Experience: Urgent Care Physcian at John Muir Medical Group
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Hello, my name is***** would be happy to assist you with your health concerns today. Please allow me a few minutes to review and respond to your question.

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Doctor: Dr. Greg, Board Certified MD replied 3 months ago

Y​our question is a very important one, that fortunately has been studied. NSAIDs exist on a spectrum, in which certain medications in this class have greater blood thinning properties, and other options have less (but more anti-inflammatory properties).

Instead of using words (only) to describe which NSAIDs are least likely to thin the blood, I have attached an image from a study which depicts the NSAIDs spectrum (see attached).

The chart shows that certain NSAIDs have more COX-2 selectivity, and others are more selective for COX-1. COX-1 selective NSAIDs are ones that thin the blood. As such, you will see aspirin on that end of the spectrum. COX-2 selective NSAIDs are mostly anti-inflammatory with minimal blood thinning effects. So, and NSAIDs like Diclofenac, Ketorolac, and Naproxen are less likely to thin the blood than Ibuprofen, Aspirin, and Ketoprofen.

I hope that this all makes sense. Please let me know if you have additional questions.

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Doctor: Dr. Greg, Board Certified MD replied 3 months ago
I sincerely ***** ***** I've answered your questions sufficiently. Please feel free to rate my service. If any additional questions arise, please let me know. Have a good night.
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