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Medication use Certain medications can irritate or damage the digestive tract and cause melena, including: Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and naproxen Bisphosphonates such as alendronate Antibiotics such as tetracycline, clindamycin, or doxycycline Iron supplements (ferrous sulfate) Potassium chloride supplements What to do: Go to the hospital for evaluation and treatment, which may involve medications or surgery to stop the bleeding