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Over-The-Counter Medicines and Bleeding Risk

People who have bleeding disorders, low platelets, or take blood-thinning medicines need to be careful about other medicines they take. Some medicines can increase the risk of bleeding. Even over-the-counter medicines that you can buy at grocery stores or pharmacies to treat pain, colds, fever, and headache can increase this risk.

What are over-the-counter medicines?

Over-the-counter (OTC) medicines are medicines that you can buy without a prescription. You do not need to see a health care provider for these products. Examples include medicines for pain, fever, headaches, cold symptoms, allergies, and stomach issues. 

Medicines that can increase risk of bleeding

People at higher risk of bleeding should avoid certain medicines. This list does not include all over-the-counter medicines that could increase the risk of bleeding. Always follow the instructions given by your care team.

Pain and fever medicines

  • Nonsteroidal anti-inflammatory drugs, often referred to as NSAIDs
    • Ibuprofen: brand names include Advil®, Motrin®, and Children’s Advil®.
    • Naproxen: brand names include Aleve®.
  • Aspirin: brand names Bayer®, Bufferin®, Excedrin®, and Goody’s® powder.

Cough and cold medicines

  • Multi-symptom medicines: brand names include Advil Cold & Sinus®, Aleve Sinus®.

Other Medicines

  • Sleep aids and other medicines that include NSAIDs or aspirin. Brand names include Advil PM®.
  • Heartburn, nausea, and upset stomach medicines that include NSAIDs or aspirin. Brand names include Alka Selzer® and Pepto Bismol®.
  • Topical medicines that include NSAIDs. Brand names include Voltaren®, Aleve®.

Safety tips for OTC medicines

  • Talk to your care team before giving your child any medicine, including nonprescription medicines. Your local pharmacist can also help you select the appropriate medicine at the pharmacy.
  • Let your health care provider know about any other medicines your child takes.
  • If your child takes more than one medicine, be sure you know about possible interactions.
  • Always read the medicine label for the dosing instructions. Know how much and how often to give the medicine.
  • Find active ingredients on the medicine label. Many products contain NSAIDs or aspirin.

If you are unsure if a product is safe for your child, ask a doctor or pharmacist.

Questions to ask your care team

  • Which over-the-counter medicines should my child avoid?
  • Which over-the-counter medicines are safe for my child?
  • What do I need to look for on the medicine label?
  • What symptoms or side effects should I watch for?
  • Who should I contact if I have questions about my child’s medicines?

Key points about over-the-counter medicines and bleeding risk

  • Over-the-counter (OTC) medicines are medicines that you can buy without a prescription.
  • Some medicines can increase the risk for bleeding. This can be dangerous if your child has a bleeding disorder, low platelets, or takes blood-thinning medicines.
  • Talk to your health care team before your child takes any new medicines, including OTC medicines.
  • If your child is at risk for bleeding, they should avoid taking medicines with NSAIDs or aspirin.
  • Read the medication label to know if a product has any ingredients that are unsafe for your child.
  • Always follow your care team’s instructions for what is safe for your child.

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The Together by St. Jude™ online resource does not endorse any branded product mentioned in this article.

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Reviewed: August 2024

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