Aspirin, ibuprofen (Advil), and naproxen (Aleve) are common pain relievers. Before taking one for a headache or fever, it’s important to know that these medicines may increase your risk of bleeding if you have immune thrombocytopenia (ITP).

ITP can also increase your risk of blood clots. In some cases, your healthcare provider may recommend taking an aspirin to help prevent them.

In this article, we’ll discuss what aspirin is, why you might take it, and any safety precautions you need to know if you or a loved one has ITP. We’ll also cover when your doctor may tell you to take aspirin and what other pain relievers you can use.

🗳️ What information would you like to know more about?

What to expect from a diagnosis

What treatment options are available

Tips for improving my symptoms

Thanks! You've successfully submitted your vote.

Sign up to view the results!

Continue with Facebook

Continue with Google

Continue with Email

By joining, you accept our Terms of Use, and acknowledge our collection, sharing, and use of your data in accordance with our Health Data and Privacy policies.

Already a member? Log In

Can You Take Aspirin While Living With ITP?

ITP is an autoimmune condition, which means the immune system mistakenly attacks healthy parts of the body. With ITP, it attacks your platelets. This may cause you to make fewer platelets. A low platelet count from ITP means your blood can’t clot as well as it should, putting you at a high bleeding risk.

Aspirin and other NSAIDs can keep platelets from clumping together as well as they normally do. If you have ITP, talk to your doctor before taking them. It’s worth noting that aspirin won’t reduce your platelet count. It just makes it harder for platelets to stick together and form clots.

Major health organizations and hospitals recommend people with ITP avoid or be careful when using OTC NSAIDs for this reason.

For the most accurate information about what medications you can take, talk to your doctor or hematology specialist first.

Treating Blood Clots in ITP

Interestingly, people with ITP can have a higher risk of blood clots in large veins in the body, although they have fewer platelets. One reason for this is that the antibodies that attack and destroy platelets in ITP leave behind even stickier platelets.

When a blood clot forms in a deep vein, it’s called deep vein thrombosis (DVT). Most DVTs form in the lower body, often in the thigh or calf.

If a clot in your leg breaks off and travels to your lungs, you may have what’s called a pulmonary embolism. This is a medical emergency, and you may need anticoagulants. These medicines help prevent the clot from getting bigger and lower the risk of new clots forming.

People with ITP have an increased risk of arterial thrombosis (a blood clot in the artery). In some cases, aspirin may be used to avoid or treat these clots to help prevent a heart attack or stroke.

About 20 percent of people with ITP are treated with low-dose aspirin to prevent arterial thrombosis. Some studies suggest that aspirin may be used safely in people with ITP after a heart attack. However, doctors have to carefully consider your platelet count and bleeding risk.

Researchers are currently reviewing the results of a recent trial in people with ITP who were taking aspirin to prevent heart attack or stroke. These findings may help guide future treatment decisions.

Aspirin May Interact With Corticosteroids

Although aspirin can help treat pain and inflammation and prevent certain types of blood clots, it can harm your stomach lining. Aspirin may cause:

• Abdominal pain
• Nausea
• Vomiting
• Heartburn

Corticosteroids (steroids) are another treatment used for ITP that can help reduce inflammation and prevent your body from making antibodies. They’re highly effective at raising your platelet count and are often the first medications doctors prescribe to treat ITP.

However, corticosteroids are also tough on your stomach and can cause vomiting and heartburn. If you’re taking a corticosteroid, like prednisone or dexamethasone, to treat your ITP, talk to your doctor before taking aspirin. It’s best to use caution to avoid side effects.

Talk With Your Doctor About Taking Aspirin With ITP

Most major hospitals and health organizations recommend that people living with ITP avoid taking aspirin. However, everyone’s case is different. Talk with your doctor before taking aspirin or any other OTC pain relievers.

If you’re at risk of a blood clot or have recently had an arterial thrombosis, such as a heart attack or stroke, your doctor may recommend you start taking aspirin. Your doctor will consider your platelet count, bleeding risk and overall health.

In some situations, such as heart disease, the benefits of taking aspirin may outweigh the risks, even if your platelet count is lower than normal. If you’ve been prescribed aspirin, be sure to follow your doctor’s instructions closely.

When you’re shopping for OTC medications, such as cold and cough medicines, read the drug labels carefully. The medications may contain aspirin or other NSAIDs. Your doctor or pharmacist can let you know which treatment options are best for you.

Acetaminophen May Be Safe To Take With ITP

Another common OTC pain reliever is acetaminophen (Tylenol). Unlike aspirin, acetaminophen isn’t an NSAID and doesn’t come with an increased risk of bleeding.

It may be safer for you to take acetaminophen to treat your fever, aches, and pains. As always, talk to your doctor first.

Take Steps To Lower Bleeding Risk

In addition to managing your medications, you can also take extra steps to lower your bleeding risk with ITP.

Here are some ways to stay safe:

• Try to prevent bruising, bumping, or cutting yourself.
• Wear hard-soled shoes when outside.
• Avoid contact sports or activities with a high risk of injury.
• Wear gloves and long pants when gardening.
• Be gentle when blowing your nose.

Most importantly, know the warning signs of serious bleeding. Call your doctor if you notice unusual bruising, blood in your pee or poop, or have bleeding that won’t stop. Get medical attention right away if you have a head injury, sudden severe headache, or confusion.

If you have questions about whether aspirin is right for you, talk to your doctor. Together, you can weigh the benefits and risks and choose the right treatment plan for you.