# Bleeding precautions at home when platelets are low

Source: https://onco.cc/protocols/bleeding-precautions-when-platelets-are-low/  
OnCo record `bleeding-precautions-when-platelets-are-low` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

When chemotherapy lowers the platelets that help blood clot, small changes at home lower the chance of bleeding: a very soft toothbrush, an electric shaver, shoes on, no aspirin or ibuprofen unless the team agrees, and firm pressure on any cut. Some signs need a call to the team straight away, such as bleeding that will not stop, blood in urine or stools, or a bad headache or change in vision.

## Summary

The home advice comes from national patient guidance: NCI's Chemotherapy and You (2023) and its thrombocytopenia page (reviewed 2022), and Macmillan (2018, under review). They agree on a very soft toothbrush, an electric shaver, care with sharp objects, shoes at all times, gentle nose-blowing, avoiding aspirin, ibuprofen and supplements without the team's agreement, firm pressure on bleeding, treating constipation, and calling about named warning signs. They differ on flossing: NCI's booklet says not to use dental floss but suggests a water flosser, its mouth-care section says to ask before flossing, and Macmillan says not to floss. None of this has been tested in a trial and none of it is graded. Platelet support is a clinical decision: NICE NG24 offers prophylactic platelet transfusion below 10 x 10^9 per litre to people who are not bleeding and not having a procedure, with exceptions (chronic bone marrow failure, autoimmune thrombocytopenia, HIT, TTP), and transfusion for clinically significant bleeding below 30 x 10^9 per litre. ASCO 2018 allows adults after autologous stem cell transplant at experienced centres to be transfused at the first sign of bleeding rather than prophylactically.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: thrombocytopenia precautions; low platelet precautions; bleeding precautions; low platelets during chemotherapy; bruising and bleeding on chemotherapy

## Connected records

- protocols: [Diet, alcohol and weight during cancer treatment](https://onco.cc/protocols/diet-alcohol-and-weight-during-cancer-treatment/), [Oral care and oral mucositis prevention during cancer treatment](https://onco.cc/protocols/oral-mucositis-prevention-and-oral-care/)
- terms: [Thrombocytopenia](https://onco.cc/terms/thrombocytopenia/)

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