LOW-MOLECULAR-WEIGHT HEPARINS AND NSAIDS

The use of an NSAIDs and a low-molecular-weight heparin increases bleeding time, although one study found that this did not adversely affect factors such as intra- operative blood loss and bruising in those undergoing hip replacement. Concurrent use is considered to be a contributing factor in the development of spinal or epidural haematoma occurring after lumbar puncture. Anticoagulants can exacerbate gastro- intestinal bleeding caused by NSAIDs.
Concurrent use is not uncommon, but prescribers should be aware that there is an increased risk of bleeding and monitor appropriately.