Be Fully Prepared For Your Surgery!

It is incredibly important to review your medication list before any procedure, as several common drugs and supplements can interfere with anesthesia or increase surgical risks.

Here is a breakdown of common medications, including blood thinners, that can affect surgery and are often paused or adjusted beforehand:

1. Blood Thinners (Anticoagulants and Antiplatelets)

These medications reduce the body’s ability to form blood clots, which is great for everyday health but can cause dangerous, excessive bleeding during and after surgery.

• Anticoagulants: Common examples include Warfarin (Coumadin), Apixaban (Eliquis), Rivaroxaban (Xarelto), Dabigatran (Pradaxa), and Heparin. Depending on the drug and the surgery, doctors typically require you to stop taking these anywhere from 24 hours to 5 days before the procedure.

• Antiplatelets: Examples include Aspirin, Clopidogrel (Plavix), and Ticagrelor (Brilinta). While low-dose aspirin is sometimes allowed to be continued, antiplatelets generally need to be stopped several days in advance to allow your blood to clot properly.

2. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Like blood thinners, over-the-counter and prescription NSAIDs inhibit platelet activity and can significantly increase your risk of bleeding.

• Examples: Ibuprofen (Advil, Motrin), Naproxen (Aleve), Diclofenac, and Meloxicam.

• Surgeons generally advise stopping all NSAIDs about 7 days before surgery.

3. Diabetes and Weight Loss Medications

Certain medications that regulate blood sugar or appetite can complicate anesthesia.

• GLP-1 Agonists: Drugs like Semaglutide (Ozempic, Wegovy) slow down the time it takes for food to leave your stomach. Even if you fast before surgery, these medications can leave you with a full stomach, increasing the risk of vomiting and aspiration while under anesthesia.

• SGLT-2 Inhibitors: These can put patients at risk for a dangerous condition called ketoacidosis when the body is fasting or under the stress of surgery.

4. Blood Pressure and Heart Medications

While you can—and often should—continue taking certain heart medications like beta-blockers, others can interact poorly with anesthesia.

• Examples: ACE inhibitors, angiotensin receptor blockers, and diuretics.

• Anesthesia naturally lowers blood pressure, and combining it with these specific medications can cause your blood pressure to drop to dangerously low levels during the operation.

5. Herbal Supplements and Vitamins

Even “natural” over-the-counter remedies can cause serious surgical complications.

• Bleeding Risks: Garlic, ginseng, ginkgo biloba, fish oil, and Vitamin E can all increase the risk of bleeding.

• Anesthesia/Heart Risks: Kava can prolong the effects of anesthesia, while ephedra can cause an erratic heart rate and high blood pressure on the operating table.

Disclaimer: Never stop taking prescribed medications without direct instructions from your healthcare provider. The timelines for stopping these drugs depend entirely on your overall health, kidney function, and the specific procedure you are having.