Medications That Increase Bleeding or May Interfere with Anesthesia

Some medications impair the body’s ability to form a clot and stop bleeding. Obviously, failure to normally form clot is undesirable around the time of surgery.

ASPIRIN: Ideally, aspirin should be discontinued a minimum of 7 (preferably 10) days prior to elective surgery. This advice includes products containing aspirin, like Percodan™.

Non-steroidal Anti-inflammatory Drugs (NSAIDs): Non-selective COX inhibitors (NSAIDs, e.g. ibuprofen, ketoprofen, Advil, Motrin, many others) should be discontinued a minimum of 5 (preferably 7) days before elective surgery. Selective COX inhibitors (COX-2 inhibitors, like Vioxx and Celebrex) CAN be continued. If you have a question about your painkiller, ask your surgeon.

Vitamins, Supplements, Herbals: Many herbal medications and supplements may increase bleeding and/or interact with medications used for anesthesia. In many cases, the exact composition of herbal supplements and the potential interactions are unknown. Specific recommendations cannot be given. Therefore, DO NOT TAKE these medications for a minimum of 7 days prior to surgery.           

Medications You May Take Before Surgery:

  • Cardiac medications (for the heart)
  • Anti-reflux medications (Prilosec, Nexium, Protonix)
  • Seizure medications (anti-convulsants)
  • Anti-hypertensives (blood pressure medications)
  • Bronchodilators (inhalers and medications for the lungs)
  • Birth control pills
  • Steroids (prednisone)
  • Immunosuppressants
  • Thyroid replacement (Synthroid)
  • Anti-Parkinson medications
  • COX-2 antagonists (Vioxx, Celebrex)
  • Opiates (without aspirin; Tylenol #3, Vicodin, fentanyl, etc)

Do Not Take These Medications Before Surgery:

  • Chewable antacids (TUMS, Rolaids, etc)
  • Diuretics (water pills, furosemide, hydrochlorothiazide)
  • Insulin
  • Oral hypoglycemics (Glucophage, Avandia, Actos, DiaBeta, Micronase, Glucotrol, Amaryl)
  • Aspirin (and aspirin-containing compounds)
  • Non-steroidal Anti-inflammatory Drugs (ibuprofen, Motrin, Advil, Mobic, Orudis, etc)
  • Potassium
  • Weight reduction agents
  • Vitamins
  • Herbs and supplements