Minor Cuts and Bleeding on Blood Thinners

When a patient on warfarin bleeds more than usual it is important to make sure that the INR is not above the desired (therapeutic) range.  If the INR is too high, i.e. the blood is too thin, warfarin may have to be interrupted; if it is very high vitamin K sometimes has to be given by the physician to lower the INR.  To help stop bleeding with minor cuts or nosebleeds, several over-the-counter products are available and  may be helpful.

1. WoundSeal®
   Formerly called QR (Quick Relief), these products contains a water-loving substance (hydrophilic polymer) and a potassium salt. Together, they work to form an artificial scab over minor cuts. It is available as a powder for skin cuts and  as a nasal applicator for nosebleeds.  Further information can be found on the company’s website.
2. Seal-On®
   These products contains cellulose and also works by forming a gel-like layer over the cut.  It is available as a spray powder, bandage, adhesive or sterile pad, blotter, or nasal sponge.  Further information can be found on the company’s website.
3. QuikClot®
   These products to stop bleeding from cuts or nosebleeds are made with a natural mineral called zeolite. Zeolite accelerates the body’s natural clotting mechanism to create a clot. Further information can be found on the company’s website or here. 
4. BloodSTOP®
   This is a product made of plant cellulose. When BloodSTOP comes in contact with blood, it forms a clear gel that seals the wound with a protective transparent layer. More information is on the company’s website.
5. NasalCEASE®
   This is made of a bio-polymer called calcium alginate. It provides a surface on which blood can clot. It can be used in the nose for nosebleeds, but als on skin cuts. More information is on the company’s website.
6. BleedArrest®
   The active ingredient in BleedArrest is a natural plant-based polymer, called amylopectin. It provides a surface on which blood can clot.  More information is on the company’s website.
7. Celox™
   Celox granules are large surface area flakes. It is said that when they come in contact with blood, they swell, gel, and stick together to make a gel like clot, which plugs the bleeding site.  Celox does not activate the normal clotting cascade.  More information can be found on the company’s website.
8. There used to be a product from Johnson & Johnson called Band-Aid Liquid Bandage which was, however, discontinued.

I am not aware of scientific, patient-based, peer reviewed publications on these products, i.e. studies on how good and effective they are.  A  number of them are being marketed in the most glowing terms – “life saving battlefield technology”, etc – with little or no published data to back up these enthusiastic statements.  Products may be available for purchase over-the-counter at pharmacies near the first aid products or can also be purchased through the internet.  There may be other products available that I am not aware of .  Also, I do not have enough experience with these products to know (a) whether they are effective in patients on blood thinners, and (b)  whether one may be more  effective than the other. Please leave a comment below or go to the Clot Connect Forum to share your experience for other patients on blood thinners as to what has helped you and what has not.

Patient Question:

Q:     “I am on warfarin and will be traveling to Africa for a few weeks. Is there anything I can take with me in case I have a cut or a nosebleed that doesn’t want to stop bleeding?”

A:     It may be reasonable to take a product along that one can apply for nosebleeds or cuts.

Disclosure: I have no financial disclosures relevant to this post.

Last updated: Sept 7th, 2011

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