Taking enoxaparin and ibuprofen together advice please

[MochaBear]

Hello, i just had a laparoscopy etc. To check my uterus for a cyst and to check if i had endometriosis which all came back normal but i was prescribed enoxaparin for 7 days. I was not told that these can interact negatively with ibuprofen and was told just to take painkillers as normal. I was even given a dose of painkillers eith ibuprofen on the same day as the nurse first injected me with the enoxaparin.
I had taken ibuprofen the following two days as well with the enoxaparin and i ended up starting my period around the same time which is heavier and painful than usual.
I checked online to see if this is caused by the blood thinning injections and stumbled across the fact that enoxaparin and NSAIDs including ibuprofen should not be taken together as they can cause internal bleeding and i am panicking now. My back is hurting immensly including my legs and i keep getting horrible lower abdomen cramping half an hour after eating or drinking and its freaking me out.. i was supposed to be feeling "better" after a few days but i still feel awful and in pain.. i have stopped the ibuprofen a few days ago (around day 3 of taking enoxaparin) but i am worried and angry that the surgeon herself and both the nurses did not tell me anything about this. I have contacted my gp via out of hours on a webform but it takes them 1 to 2 working days to get back so asking for advice on here . Has anyone else made such a mistake and ended up being okay? Please?

You are absolutely right, you shouldn’t take ibuprofen and Enoxaparin together. Call 111 for advice and start wording your complaint. I hope you are ok.

we routinely prescribe ibuprofen and enoxaparin together. If you're worried about your symptoms get advice, but the prescribing was not at all off piste.

It's bad that the doctor, nurse or ohsrmacidt didn't warn you about the increased risk of bleeding. If the pain has changed and increased it would be a good idea to call 111, it could be anything but they will probably advise you to ho to hospital. Hope you feel better soon.

Do you check bloods, prescribe ppi and advise patients to seek medical help if they have new pain or increased bleeding?

It’s a well known interaction so I am surprised you routinely prescribe them together. It’s not really advisable.

depends on the case. Most patients will have had bloods done pre-op and those do normally get checked. Most people don't need a long course of the NSAID and are back to eating and drinking pretty quickly which affords some gastric protection, but where a longer course is needed/a patient already takes a PPI or is at particular risk then a PPI might be given too. The risk of increased bleeding isn't usually high with the combo of prophylactic lmwh and ibuprofen for most people (it really is quite routine post op prescribing). It can be pretty normal for periods to go on the wonk post-op (early/late/light/heavy), particularly if they've been in your uterus during the procedure. But, yes, post operatively any patient with increased pain or worries about bleeding should consider seeking advice - 111 is probably your best bet at this time of day.

Hi thanks everyone i have just contacted 111 and waiting for a call back from the doctor now. He said i should get a call back within the next 2 hours.

But i am shocked that nothing other than where to inject the enoxaparin was explain to me and that too where one nurse told me to count to ten before taking it back out and the other telling me i dont need to do that and also showing me to inject it under my belly whereas the one before her said to inject it on either side of my belly.. the surgeon herself earlier than that stopped by and just told me that she didnt find anything and that the cyst and the suspected endometriosis was not there and told her nurse to prescribe enoxaparin and just walked off. No explanation as to why i have the pelvic pain or furthur plan etc.

Do let us know how you get on. I’ve been on Enoxaparin for three months and was told not to take ibuprofen or anything similar. I’m interested to see what 111 say.

Wishing you all the best @MochaBear .

@Perseimmion hi thanks, i got a call back and the doctor was absolutely awful.. he was talking down to me and plain rude and he sounded foreign so was struggling to understand him very well as he keot stuttering and mumbling.. anyway he just told me to stop taking ibuprofen and as long as i am not bleeding from my nose or no rectal bleeding nor coughing up blood then im most likely okay but he can book me in to be seen at A&E for an assessment..
I told him if he is not concerned about anything else then i will just wait for my gp to get back to me as i have sent them a message on their out of hours form via their website.. i would probably be waiting at A&E all night on an uncomfortable chair which isnt ideal while recovering from 4 incisions and i am sure there are others who need to be there more than i do

I'd ask why you needed the enoxaparin in the first place if you had keyhole, no other surgery and are up and walking about. What dose did they prescribe.

@MissMoneyFairy i am assuming it was because i had to stay overnight because i was feeling very weak and was shivering and struggling to get my temperature up so i wasnt really back on my feet for that one night.. it was one injection every day for 7 days but i didnt bother taking the 7th one which was supposed to be taken yesterday