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Serious recurring nasal bleeding (senior, 70+ years)

My mother, who is in her late seventies, has recently suffered several incidents of bleeding from her sinus, and most recently from a nostril. On one occasion she lost nearly 2 pints of blood. She had a CT scan which revealed nothing. There has been a few attempts at cauterizing the bleeding areas, however the problem is recurring. The first incident occurred approximately six months ago.

(I have mistakenly posted this in the communities forum, having noticed the different forums I have posted here in hopes of a response from "Ask a Doctor", my apologies for the double post)

She has a history of cartilage loss in an ankle (due to an injury sustained while in her thirties) for which she has been given medications including cynabisk (phonetically spelled, my apologies, I will attempt to get a complete list) which was discontinuedabout a year and a half ago.
Currently she is taking Actonel (Risedronate) for which I have found some information suggesting it may be related (rhinitus, sinusitis):

1. quoted from: http://www.merck.com/mmpe/lexicomp/risedronate.html


- Respiratory: Bronchitis (3% to 10%), pharyngitis (6%), rhinitis (6%) dyspnea (4%)

- Miscellaneous: Flu-like syndrome (10%), acute phase reaction (?8%; includes fever, influenza-like illness)

<1%, postmarketing, and/or case reports: Allergic reaction, angioedema, arthritis, bullous skin reaction, cough, dysphagia, esophagitis, esophageal ulcer, gastric ulcer, hypersensitivity reaction, iritis, joint pain, liver function test abnormality, musculoskeletal pain (rarely severe or incapacitating), osteonecrosis (primarily of the jaw), sinusitis, uveitis

coagulopathy is also mentioned as a risk factor in association with Osteonecrosis of the jaw (which is not something she has been diagnosed with)

2. quoted from: http://74.125.47.132/search?q=cache:ECXA4vIPeEoJ:www.drugbank.ca/drugs/DB00884+Actonel+side+effects+contra-indications+nose+bleed&cd=7&hl=en&ct=clnk&gl=ca

- Side effects include abdominal pain, anxiety, back pain, belching, bladder irritation, bone disorders and pain, bronchitis, bursitis, cataracts, chest pain, colitis, constipation, depression, diarrhea, difficulty breathing, dizziness, dry eyes, eye infection, flu-like symptoms, gas, headache, high blood pressure, infection, insomnia, itching, joint disorders and pain, leg cramps, muscle pain, muscle weakness, nausea, neck pain, nerve pain, pain, pneumonia, rash, ringing in ears, sinus problems, sore throat, stomach bleeding, stuffy or runny nose, swelling, tendon problems, tumor, ulcers, urinary tract infection, vertigo, vision problems, and weakness.


Is there any information to suggest that this drug may be a contributing factor?
Can any suggestions be made as to further routes of investigation, possible causes, or treatment?

The physicians and specialists she has seen have not been able to determine a cause, any advice would be greatly appreciated. She lives in Canada.
1 Responses
363281 tn?1518219421
COMMUNITY LEADER
Oh wow, well, this is not the "Expert doctor forum" but I will try to answer. First, I imagine you are very frustrated with this and she must be as well. The only thing I can think of is her capillaries in her nose are breaking due to weak capillary walls and this can sometimes be helped with taking "Bioflavonoids" these are a vitamin similar to Vitamin C and they help keep the capillaries strong.

Also, her nose linings could be very dry, and I would suggest putting a dab of neosporin ointment up each one, this will keep them lubricated, also, have you tried a humidifier in her room?

Wow, the actonel really has a lot of side-effects, this could be part of the problem as I noted it mentioned the sinuses and related problems.

I wish I knew more, hopefully a doctor in the "expert" forum will be able to give you more insight on all this.
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