Rivaroxaban exerts anticoagulant effects by inhibiting coagulation factors, and bleeding is its main adverse reaction. Correctly identifying and managing bruising, nosebleeds, and gastrointestinal bleeding can help balance the benefits of anticoagulation with the risk of bleeding.

1、 Management of bruising

1. Common manifestations

Bruising is a common mild bleeding manifestation of rivaroxaban, often caused by subcutaneous bleeding after bumps or minor injuries, manifested as skin bruising and bruising.

2. Daily prevention

Avoid violent collisions in daily life, use a soft bristled toothbrush, and use an electric shaver when shaving to reduce skin and mucosal damage.

3. Local processing

Small area bruises generally do not require special treatment. Early cold compress and later warm compress can be applied with the doctor's permission to promote absorption. Avoid rubbing vigorously.

4. Observe changes

Pay attention to whether the scope of bruising has expanded, whether it occurs frequently, or if there is no obvious cause. If bruising occurs repeatedly or has a large area, the doctor should be informed.

5. Situations requiring medical attention

If bruising is accompanied by significant swelling, increased pain, restricted mobility, or other bleeding symptoms, timely medical evaluation should be sought.

2、 Management of nosebleeds

1. Common causes

Dry nasal mucosa, digging the nose, forcefully blowing the nose, and inflammation of the nasal cavity can all induce nosebleeds. It is more likely to occur when the climate is dry.

2. Home hemostasis methods

Maintain a seated position, lean forward slightly, pinch the sides of the nose with your fingers, and continue to press for 10 to 15 minutes while breathing through your mouth.

3. Auxiliary measures

Cold compress can be applied to the bridge of the nose to promote vasoconstriction. Avoid looking up to prevent blood from flowing into the throat and causing coughing or aspiration.

4. Nasal moisturizing

You can use physiological saline spray or apply a small amount of Vaseline to keep the nasal mucosa moist and reduce the risk of bleeding.

5. Situations requiring medical attention

If the bleeding cannot be stopped after 15 to 20 minutes of compression, or if the bleeding is large, recurrent, and accompanied by dizziness and fatigue, medical attention should be sought immediately.

6. Medication adjustment

Frequent nosebleeds may be related to anticoagulant strength, and the doctor should be informed to assess whether dosage adjustment or further examination is necessary.

3、 Management of gastrointestinal bleeding

1. Be alert to symptoms

Gastrointestinal bleeding can manifest as black stools, tarry stools, vomiting blood, coffee grounds like vomit, and may also be accompanied by abdominal pain, dizziness, fatigue, and pale complexion.

2. High risk factors

Individuals with a history of peptic ulcers, gastritis, esophageal varices, and concurrent use of nonsteroidal anti-inflammatory drugs or antiplatelet drugs have a higher risk of gastrointestinal bleeding.

3. Seek medical attention immediately

Once vomiting blood, black stool or a large amount of rectal bleeding occurs, the medication should be stopped immediately and emergency medical treatment should be sought. Self observation or delay is not allowed.

4. Notify during medical treatment

When seeking medical attention, it is important to proactively inform the doctor that they are currently taking rivaroxaban, as well as the dosage and last time of medication, in order for the doctor to quickly assess and handle the situation.

5. Hospital treatment

Doctors may perform blood routine, coagulation function, gastroscopy and other examinations, and provide treatment such as fluid replacement, blood transfusion, proton pump inhibitors or endoscopic hemostasis according to the situation.

6. Preventive measures

Individuals with a history of digestive ulcers should actively seek treatment for the underlying disease. Avoid self medication with nonsteroidal anti-inflammatory drugs. When necessary, doctors may add proton pump inhibitors to protect the gastric mucosa.

7. Restore anticoagulation

Whether and when to resume rivaroxaban after bleeding control should be determined by the doctor based on the risk of thrombosis and bleeding. Patients cannot resume medication on their own.