ABC7’s The More in the Morning team spoke with Dr. Michael K. Kim, Board-Certified Plastic Surgeon, to discuss what specific medications and supplements you should stop taking prior to going in for surgery. In essence, there are certain foods that may interfere with anesthesia, bleeding time, immune function, and healing time. These items should be avoided. Vitamin E, vitamin C, vitamin K, B vitamins, fish oils, and all herbal supplements should all be STOPPED 1 week pre-surgery (including your multivitamin).
If you’re planning to have surgery, you may need to take a break from some supplements and medications that can interfere with anesthesia. Surgical complications could include heart or bleeding problems, prolonged anesthesia effects, or increased blood pressure.
Medications to stop before surgery:
Anticoagulants, more commonly known as blood thinners, reduce the body’s ability to clot and increase the risk of serious bleeding. Blood thinners come in prescription and over-the-counter form.
- Prescription: warfarin, heparin, Xarelto, Eliquis, and Plavix, among others.
- Over the counter: aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
Other Common Medications to Avoid Prior to Surgery:
- Aspirin (Anacin, Ascriptin, Bayer, Bufferin, Ecotrin, Excedrin)
- Choline and magnesium salicylates (CMT, Tricosal, Trilisate)
- Choline saliclate (Arthropan)
- Celecoxib (Celebrex)
- Diclofenac potassium (Cataflam)
- Diclofenac sodium (Voltaren, Voltaren XR)
- Diclofenac sodium with misoprostol (Arthrotec)
- Diflunisal (Dolobid)
- Etodolac (Lodine, Lodine XL)
- Fenoprofen calcium (Nalfon)
- Flurbiprofen (Ansaid)
- Ibuprofen (Advil, Motrin, Motrin IB, Nuprin)
- Indomethacin (Indocin, Indocin SR)
- Ketoprofen (Actron, Orudis, Orudis KT, Oruvail)
- Magnesium salicylate (Arthritab, Bayer Select, Doan's Pills, Magan, Mobidin, Mobogesic)
- Meclofenamate sodium (Meclomen)
- Mefenamic acid (Ponstel)
- Meloxicam (Mobic)
- Nabumetone (Relafen)
- Naproxen (Naprosyn, Naprelan)
- Naproxen sodium (Aleve, Anaprox)
- Oxaprozin (Daypro)
- Piroxicam (Feldene)
- Rofecoxib (Vioxx)
- Salsalate (Amigesic, Anaflex 750, Disalcid, Marthritic, Mono-Gesic, Salflex, Salsitab)
- Sodium salicylate (various generics)
- Sulindac (Clinoril)
- Tolmetin sodium (Tolectin)
- Valdecoxib (Bextra)
It is also advisable to abstain from Birth Control, such as Birth control pills, Estrogen replacement, and Estrogen creams or patches.
Certain psychiatric and weight loss medications can cause potentially harmful interactions with anesthetic medications. Please let your surgeon and anesthesia team know if you are taking these before surgery.
If you take diabetes medication, we will give you instructions based on your specific medications and dosages. Because you won’t be eating on the day of surgery, we may ask you to hold or decrease many of these medications.
Of course, with some medications, stopping would be unsafe. A few drugs we should know about – but likely won’t ask you to stop taking – include beta blockers for high blood pressure, proton pump inhibitors for acid reflux, statins, inhalers for asthma, anti-seizure medications, antibiotics, and acetaminophen (such as Tylenol).
Supplments to stop before surgery:
Unlike prescription and over-the-counter medications, herbal and dietary supplements aren’t as heavily regulated by the U.S. Food and Drug Administration (FDA). Dr. Michael K. Kim strongly advocates that patients abstain from these 10 common supplements at least seven days before surgery:
- CBD oil: While more research is needed, preliminary studies suggest CBD oil can increase the risk of bleeding.
- Echinacea: Used to boost the immune system, this herb can harm the liver.
- Ephedra: This herbal appetite suppressant can cause high blood pressure and erratic heart rate during surgery.
- Garlic: Used to lower blood pressure and cholesterol, garlic in supplement form can increase the risk of bleeding.
- Ginkgo: This herb is used to improve memory but can increase the risk of bleeding.
- Ginseng: Used to boost energy, ginseng can cause increase the risk of bleeding.
- Kava: Used to relieve anxiety but can prolong the effects of anesthesia.
- St. John’s wort: This herb is used to relieve depression and anxiety, but it can interfere with anesthesia medicines and prolong their effects.
- Valerian: Used to relieve anxiety or as a sleep aid, this herb can interfere with anesthesia medicines, prolonging their sedative effects.
- Vitamin E: This vitamin can increase the risk of bleeding.
Like medications, there may be circumstances in which we ask you to continue taking a supplement. For example, Dr. Kim might ask you to keep taking vitamin D or calcium if you’re having thyroid or parathyroid surgery, or an iron supplement if you have iron deficiency anemia.