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What to do if…
you are on blood thinners and develop a new headache or unexplained bruising

Short answer

If you’re on a blood thinner and have a new headache or unexplained bruising, get urgent medical advice today. If the headache is sudden/severe, you have any neurologic symptoms, or you had a recent head injury/fall, call 911 or go to the ER now.

Do not do these things

  • Do not “wait it out” if the headache is new, worsening, or unusual for you.
  • Do not take aspirin or NSAIDs (like ibuprofen/naproxen) unless your clinician has already told you they’re safe with your blood thinner.
  • Do not stop or skip doses “just in case” without urgent clinical advice. If you’re going to the ER/911 for suspected serious bleeding, do not take further doses unless a clinician tells you to, and bring your medication bottles/list.
  • Do not drive yourself to urgent care/ER if you feel faint, confused, or your vision/speech is affected.
  • Do not add new over-the-counter medicines or supplements without checking first (some increase bleeding risk or interact with anticoagulants).

What to do now

  1. Check for “go now” signs and use emergency care if present.
    Call 911 (or go to the ER) if you have:

    • a sudden, severe, or “worst” headache
    • new confusion, fainting, extreme sleepiness, seizure
    • weakness/numbness on one side, facial droop, trouble speaking, vision changes, new imbalance
    • a headache after a fall, car crash, sports impact, or any head bump
    • vomiting blood or “coffee-grounds” material, black/tarry stools, red urine, bleeding that won’t stop, or you feel very weak/lightheaded

  2. If it’s not an emergency, contact a clinician urgently today.

    • Call your prescribing clinician, anticoagulation clinic, or primary care office and say:
      “I’m on a blood thinner and I have a new headache and/or unexplained bruising.”
    • If you can’t reach anyone promptly, go to an ER/ED (urgent care may not be able to evaluate anticoagulant-related bleeding safely).

  3. Identify your blood thinner and last dose time (this changes what clinicians do next).
    Have ready: medication name (warfarin/Coumadin or a DOAC like apixaban/Eliquis, rivaroxaban/Xarelto, dabigatran/Pradaxa, edoxaban/Savaysa), dose, and time of last dose.

  4. If you take warfarin, ask whether you need an urgent INR check.
    Unexpected bruising or headache can be a reason for evaluation and possibly lab work. Bring your INR log/clinic contact if you have it.

  5. Look for other bleeding symptoms you might have overlooked.
    Easy or spreading bruises; gum bleeding; frequent nosebleeds; unusually heavy menstrual bleeding; pink/red/brown urine; red or black stools; vomiting blood; dizziness/weakness.

  6. Make the next few hours safer while you arrange care.

    • Avoid activities where a fall or bump could happen.
    • If possible, have someone stay with you and keep your phone nearby.
    • Gather medication bottles and a list of other meds/supplements.

What can wait

  • You do not need to decide today whether you should stop anticoagulation long-term — that depends on your clot risk and should be guided by a clinician.
  • You do not need to pinpoint the cause of the bruising or headache before seeking help.
  • You do not need to “prove” it’s serious by taking pain meds first (some are unsafe with blood thinners).
  • You do not need to contact multiple services at once; one urgent clinical contact is enough unless emergency symptoms appear.

Important reassurance

Feeling scared is a normal response — blood thinners are important medicines, and new symptoms can feel ominous. The goal is not to panic-stop your medication, but to get timely evaluation so bleeding complications are caught early and treated safely.

Scope note

This guide is first steps only for the next few hours. Follow-up testing, medication adjustments, and investigating bruising causes should be done with your healthcare team.

Important note

This is general information, not a diagnosis or personalized medical advice. If symptoms are severe, sudden, worsening, or you’re unsure, choose emergency care.

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