What Causes Easy Bruising? 6 Medications to Watch For

We all experience a bruise or some bleeding every now and then. But some people may bruise and bleed more easily, and it can sometimes become excessive and serious.

There are many reasons why you might get more bruises or more serious ones. One that’s often overlooked is side effects of certain medications and supplements. Here we’ll discuss what to look out for and when to see your healthcare provider.

What can cause easy bruising?

A bruise is a collection of blood under the skin, and tears in your blood vessels can lead to bleeding.

Some causes of easy bruising are more obvious. Bruising and bleeding usually happen after an injury — like banging your knee against a table. And some people might be more prone to bumping into things. As you get older, thinning skin can also lead to more bruising because your skin can’t protect your blood vessels as well.

It’s also important to be aware that certain health conditions can lead to easier bruising and bleeding. Some examples include:

• Bleeding disorders: For example, von Willebrand disease is a bleeding disorder that runs in the family. People with this health condition have platelets that don’t work well enough to stop bleeding. Platelets normally stop bleeding by sticking together and forming a plug.

• Low vitamin C or vitamin K: Vitamin C is important for wound healing, and vitamin K helps control bleeding. If you’re not getting enough vitamin C or K from your diet, you may be more prone to bruising and bleeding.

• Liver disease: The liver is responsible for making proteins that control bleeding. If you have liver disease and your liver can’t make enough of these proteins, you may bruise or bleed more easily. One common cause of liver disease is heavy alcohol use.

• Cancer: People with certain cancers — specifically blood cancers — may not have enough platelets. Some cancer treatments can also cause platelet levels to drop.

Then, there are the side effects of certain medications and supplements. This is a more common cause of easy bruising than many people realize.

Medications that may cause easy bruising

These six types of medications are common offenders. For more information about these medications, speak with your pharmacist or healthcare provider.

1) Antiplatelet medications

Antiplatelet medications — like aspirin and clopidogrel (Plavix) — are typically recommended after a heart attack. Too many platelets clumping together can raise your risk of clots and heart attacks. Antiplatelets help prevent this excessive clumping or clotting. Blocking platelets from working, however, can also cause easy bruising and bleeding.

2) NSAID pain relievers

NSAIDs (non-steroidal anti-inflammatory drugs) — like ibuprofen (Motrin, Advil) and naproxen (Aleve) — are typically used to relieve pain and fever. But a possible side effect of NSAIDs is bleeding.

NSAIDs may cause easy bruising and bleeding because they affect how well platelets work. This risk is greater when you combine NSAIDs with other blood thinners, such as antiplatelets or anticoagulants.

3) Anticoagulants

If you have a medical condition that raises your risk for blood clots, like atrial fibrillation (a type of abnormal heart rhythm), your healthcare provider may recommend that you take an anticoagulant.

In general, anticoagulants work by blocking special proteins known as clotting factors that normally control bleeding. While this can help prevent blood clots, it can also cause easy bruising and bleeding. Some examples of anticoagulants include:

• Warfarin (Coumadin, Jantoven)

• Enoxaparin (Lovenox)

• Rivaroxaban (Xarelto)

• Apixaban (Eliquis)

4) Steroids

Steroids are common medications used for a wide variety of conditions, from asthma and rheumatoid arthritis to skin issues like psoriasis. Some examples of steroids include prednisone and hydrocortisone. 

Steroids have a number of side effects, one of which is possible collagen damage. Destroying collagen may thin out the skin, and thin skin is linked to easy bruising and bleeding.

5) Some antibiotics

Penicillins and cephalosporins are two types of commonly prescribed antibiotics that treat certain bacterial infections. Rarely, they can cause a side effect known as thrombocytopenia. This is a condition where you don’t have enough platelets, which can lead to easy bruising and bleeding. 

Amoxicillin and ampicillin are examples of popular penicillins. And some examples of cephalosporins include cephalexin (Keflex), cefaclor, and cefuroxime-axetil.

6) SSRI antidepressants

SSRIs (selective serotonin reuptake inhibitors) are a type of antidepressant, and they’re used for many mental health conditions. Some examples of SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). 

SSRIs also have a rare but potentially serious side effect of easy bruising and bleeding. The risk of this side effect is greater when SSRIs are combined with certain medications that also increase the risk for bleeding, like NSAIDs. Similar to NSAIDs, SSRIs block platelets from working.

Can supplements cause easy bruising too?

Yes, taking certain dietary supplements may also lead to easy bruising and bleeding. And some may interact with the medications listed above to make this even more likely. Always remember to speak with your healthcare provider or pharmacist before adding supplements to your daily regimen.

We discussed how important platelets and clotting factors are in controlling bruising and bleeding. You need both to form a barrier to slow down and stop bleeding. Some supplements can work against platelets. Here are some popular examples: 

• Garlic

• Ginger

• Gingko

• Turmeric

Some supplements may work against clotting factors, like: 

• Chamomile

• Fenugreek

• Red clover

Some supplements can also prevent both platelets and clotting factors from working well, for example: 

• Dong quai

• Evening primrose

• Ginseng

• Omega-3 and fish oil supplements

When to talk my healthcare provider about easy bruising

Excessive bruising and bleeding can alert you and your healthcare provider to a serious health condition that you didn’t know about. But they can also be dangerous if they happen too often or are so serious they don’t heal. Talk with your healthcare provider right away if you notice the following:

• Large or frequent bruising, but you don’t know what caused it

• Changes in where and how often you get bruises on your body

• Bleeding that doesn’t go away after 10 minutes

• Frequent nose bleeds over five times per year

• Heavy menstrual periods that last more than 7 days

• Heavy menstrual periods that require frequently changing your pad every 2 hours  

Why trust our experts?

Written by:

Ross Phan, PharmD, BCACP, BCGP, BCPS

Ross Phan is a board-certified clinical pharmacist. She has roughly two decades of healthcare experience — with most of her experience being pharmacy related.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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