I'm used to regularly giving my blood and other blood components (plasma and platelets), but I was surprised the other day to see that one should not proceed to the donation if they consumed anti-inflammatory pills less than 8 days before. I understand how some painkillers may act as a blood thinning (e.g. the aspirin), but if I recall correctly, anti-inflammatory pills do not necessarily have that impact on blood. Then why is blood donation compromised if the donor recently consumed that kind of pills?
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1My first inclination would be a possible drug interaction with the transfusee, (i.e. the person receiving the blood may be allergic to the drug), though if that were true, then you'd expect that one should not give blood after taking any drugs.– BillDOeCommented Oct 2, 2018 at 18:51
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5I think you need to specify which anti-inflammatory drugs. According to this you can donate after taking NSAIDs such as ibuprofen, and you can donate plasma if you've taken aspirin. Aspirin only precludes platelet donation for 48 hours.– Carey Gregory ♦Commented Oct 2, 2018 at 19:30
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@CareyGregory I was thinking ibuprofen (because it's the only one I take and therefore could prevent me from donating). Also, thanks for sharing. However, this may not apply in my country (I already looked it up online and couldn't find anything about it except the restriction duration).– avazulaCommented Oct 4, 2018 at 14:13
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1@CareyGregory Weird. I thought platelet recovery took 96, not 48 hours. This got me curious why the NIH says 48 hours are sufficient.– NarusanCommented Oct 5, 2018 at 13:18
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@Narusan Yeah, that surprised me too. Maybe the reasoning is that after 48 hours enough new platelets have been created to meet some minimum requirement?– Carey Gregory ♦Commented Oct 5, 2018 at 13:31
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2 Answers
For this answer, I'll assume that with “anti-inflammatory pills” we're exclusively talking about NSAIDs.
In summary, I see multiple reasons why donors have to wait a few days after taking NSAIDs. In summary:
- To get fresh platelets into their blood
- To decrease the odds of inadvertently transmitting a masked infection
- To prevent directly transmitting NSAIDs to the patient.
1. Platelets
Aspirin inhibits platelet activation by irreversibly acetylating their COX enzymes[1]. The average lifespan of a platelet indeed is around 8-10 days[1]. However, let's say you take aspirin once on day 1, then you'll be inhibiting young and old platelets alike. On day 4-5, about half of those inhibited platelets will have been replaced by new and uninhibited platelets.
2. Infection Transmission
Infections often present with fever, pains/discomfort, and 'feeling sick'. NSAIDs are analgesic and antipyretic, so NSAIDs could theoretically 'mask' an infection. Given the myriads of possible incubation periods and contagion durations of infections, mandating a waiting period can be used as a general method to reduce the risk of transmitting a 'hidden' pathogen.
3. Plasma Contamination
NSAIDs are capable of providing some incredibly dangerous side effect.
For example, Stevens-Johnson syndrome, toxic epidermal necrolysis can be caused by NSAIDs[2]. These side effects are rare, but they can be deadly.
Moreover, birth defects can result from taking NSAIDs during the pregnancy[2].
Waiting 8 days should be sufficient to 'wash out' NSAIDs from the donor's plasma in most cases, even for those with longer half lives (e.g. Etoricoxib has a half-life of about 22 hours[3])
[1] Rang and Dale, ISBN-13: 978-1-4377-1933-8, Chapter 26: Anti-inflammatory and immunosuppressant drugs
[2] https://www.farmacotherapeutischkompas.nl/bladeren/preparaatteksten/i/ibuprofen__systemisch_
[3] DOI: 10.1345/aph.1E543, PMID: 15827069
Although ACCP recommends 7- to 10-day aspirin intake cessation before surgery in patients with low cardiovascular risk, the results of our study suggest that aspirin intake cessation not longer than 96 hours can be adequate.
The recommendation to stop aspirin intake for 7 to 10 days is based only on the concern for the mature platelets during exposure to aspirin.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008770/#!po=66.9355.
There are some mechanisms that may modulate the antiplatelet effects in the presence of aspirin and after aspirin cessation:-
Immature platelets, which are reticulated and larger, have less attenuated and more elevated platelet activity than mature platelets in the presence of aspirin. Moreover, the inhibition of human megakaryocyte cyclooxygenase with low doses of aspirin is incomplete, and megakaryocyte cyclooxygenase seems to recover within 12 hours after aspirin ingestion.
Interruption of the platelet function by aspirin results in the production of new platelets, presumably through the action of a feedback system controlling thrombocytopoiesis. These newly formed platelets may help in speedy recovery of the platelet activity.
These mechanisms above are responsible for speedy recovery of platelet activity before the average lifespan of platelets.
The concern for mature platelets (as I have mentioned in the quotation box) can also be applied to individuals before platelet donation i.e to wait for average lifetime of platelets which is 7-10 days (the duration which you are backing up in your question, without any reference, at least for me) before donation. Otherwise, according to who guidelines one must defer from donating blood 5 days after taking aspirin and 48 hrs after taking other NSAIDS (The blood bank nearby me defer from donating for 3 days).
