Merck Manual

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Some Causes of Excessive Bleeding

Some Causes of Excessive Bleeding



Platelet disorders

Decreased number of platelets

Cirrhosis if the spleen is enlarged

DIC if it progresses rapidly

Drugs that can trigger destruction of platelets (including heparin, quinidine, quinine, sulfonamides, sulfonylureas, or rifampin)

Increased number of platelets (which often causes excessive clotting but sometimes causes excessive bleeding)

Inadequate platelet function

Drugs that can cause platelets to malfunction (including aspirin or other NSAIDs)

Clotting disorders


Anticoagulants (drugs that inhibit clotting) including heparin, warfarin, or DOACs (including dabigatran, apixaban, edoxaban, and rivaroxaban)

DIC if it progresses slowly


Blood vessel disorders



Connective tissue disorders (such as Marfan syndrome)

DIC = disseminated intravascular coagulation; DOAC = direct oral anticoagulant; HIV = human immunodeficiency virus; NSAIDs = nonsteroidal anti-inflammatory drugs; vWF = von Willebrand factor.