ANTICOAGULANTS From: orchid@buffnet.net I have recently encountered a great difficulty in controlling bleeding during a relatively routine excision of a medium size BCC. Patient's list of medications was extensive but did not indicate any of the well known "blood thinners". On persistent questioning the patient admitted that he was also taking a new (for him) arthritis medication whose name he did not recall. The next day he called the office to spell the name of Daypro. I wonder if the readers of this group could come up with a list of any other oral medications implicated in prolonged bleeding (well documented like coumadin, warfarin, aspirin or anectotal from own experience). This might be helpful to all. ================ From: KSmithDerm@aol.com One BIG anticoagulant is ETHANOL - I hate it when someone comes in the morning after a big party, or even worse, after a shot or two of liquor; in particular if they are on ASA. Another thing is GARLIC - high doses [eg. health food store pills] can lead to bleeding problems. ============================== From: FVJB41A@prodigy.com ( DANIEL M SIEGEL) Tree funghi (used in chinese food; see a letter in the NEJM anout 15 years ago.) Estrogen -high dose. Ethanol. Garlic. Chewers of birch bark and other salicilate containing plants. ======================= From: Haines Ely The most common offenders in my practice: All NSAIDS, Vitamin E, All calcium channel blockers, and "antioxidant" formulations. Its is synchronious that I received this e-mail today. I just spent my entire lunch hour trying to stop the bleeding from a forehead BCC excised from a physician. He was on Ibuprofen, Diltiazem, and vitamin E. The classic agents mentioned above. The combination produces profound anticoagulation. Much more than I've seen with coumadin or heparin.