Bleeding disorders advice to reduce bleeding risk

Avoid injuries	Do not participate in certain high-contact sports and activities with a high risk of injury (individualized decision). Take measures to reduce the risk of falls. Wear seatbelts. Use protection during sports (knee and elbow pads, mouthguards, helmets).
Avoid infections	Maintain good dental hygiene. Obtain appropriate vaccinations.
Medications	Avoid aspirin or NSAIDs for routine fever reduction or aches and pains (use acetaminophen instead). Selective cyclooxygenase (COX)-2 inhibitors such as celecoxib are not expected to affect platelet function substantially. Long-term glucocorticoids may increase bleeding risk. Selective serotonin reuptake inhibitors can interfere with platelet function; decisions about use are individualized. Review over-the-counter supplements Some cold and flu medications may contain an NSAID. Bleeding risk may be increased by certain herbal preparations and dietary supplements (vitamin E, garlic, gingko biloba). Fish oil is often cited, but evidence for increased bleeding risk is lacking.
Alcohol	Avoid excess alcohol, which can increase bleeding risk by several mechanisms.
Communication	Consider a medic-alert bracelet or wallet card. Learn to recognize signs of bleeding. Have a plan of whom to contact or where to go for injuries or signs of bleeding. Inform all physicians and dentists about the bleeding disorder.

Additional advice for epistaxis, heavy menstrual bleeding, and pregnancy/delivery is presented in UpToDate.

NSAID: nonsteroidal antiinflammatory drug.

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