Which medications should not be used in hemophilia?

Under normal circumstances, patients with hemophilia should avoid using medications such as enteric-coated aspirin tablets, ibuprofen sustained-release capsules, warfarin sodium tablets, clopidogrel hydrogen sulfate tablets, and dipyridamole tablets. The specific reasons are as follows:

1. Enteric-coated Aspirin Tablets

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits platelet aggregation. Patients with hemophilia already have deficiencies in clotting factors and impaired coagulation function. Using this medication further weakens platelet-mediated hemostasis, increasing the risk of bleeding—such as skin bruising, gum bleeding, or joint hemorrhage—and therefore it must be strictly avoided.

2. Ibuprofen Sustained-Release Capsules

Ibuprofen is also an NSAID with clear anti-inflammatory and analgesic effects. However, it inhibits prostaglandin synthesis, which affects platelet aggregation, and may damage the gastric mucosa, leading to gastrointestinal bleeding. In hemophilia patients, its use can not only worsen coagulation disorders but also trigger or exacerbate bleeding symptoms; thus, it is not recommended.

3. Warfarin Sodium Tablets

Warfarin sodium is an anticoagulant that reduces blood clotting ability by inhibiting the synthesis of vitamin K-dependent clotting factors. Since hemophilia patients already lack clotting factors, taking this drug further disrupts the coagulation balance and may easily lead to severe bleeding events such as intracranial hemorrhage or major gastrointestinal bleeding. It is absolutely contraindicated.

4. Clopidogrel Hydrogen Sulfate Tablets

Clopidogrel is an antiplatelet agent that selectively inhibits platelet aggregation. Hemophilia patients already have inherent defects in their coagulation system. Using this drug further impairs platelet involvement in hemostasis, increasing both the frequency and severity of bleeding episodes, which is highly detrimental to disease management. Its use should be avoided.

5. Dipyridamole Tablets

Dipyridamole inhibits platelet aggregation and also causes vasodilation. In hemophilia patients, this creates a dual effect: suppression of platelet hemostatic function combined with increased bleeding tendency due to vessel dilation, making it easier to trigger or worsen bleeding—such as nosebleeds or joint cavity hemorrhages. Therefore, it must be avoided.

In daily life, patients should avoid strenuous exercise and trauma to minimize potential triggers for bleeding. If symptoms such as pain or fever occur, prompt medical attention is necessary. Only medications deemed safe under a physician's guidance should be used. Self-medication must be strictly avoided to prevent serious complications.