Microsoft word - med use prior 2 surgery.doc

MEDICATION USE PRIOR TO SURGERY
Certain medications, including herbal products, over-the-counter products (OTC), and prescription medicines can cause serious complications before and after surgery. These complications may include increased bleeding, altered heart function, cardiac instability, altered immunity, impaired healing capability, increased sedation, increased drug metabolism, and decreased blood glucose levels. Due to the seriousness of these conditions, it is important to talk to a healthcare professional prior to any surgical procedure about all current medication use.
As a reminder, the Federal Drug Administration (FDA) does NOT regulate herbal products; consequently, the efficacy and
safety of these products have not been fully recognized. The following 8 herbals are among the most common herbals used
and have been studied for their potentially harmful effects during surgery. Remember to check the labels on all herbal
products for potentially harmful ingredients. Charted below is the recommended discontinuation time for herbal products prior
to surgery. Talk to your health care professional about all herbal products that you are currently taking.
RECOMMENDED STOP TIME
Stop as far in advance as you can, especially if you are a transplant patient or have liver impairment Try to taper weeks before surgery; if not, continue until surgery. Talk to physician about potential Other herbals of caution: Stop 2-3 weeks before surgical procedure Diet aids, Feverfew, Licorice, Metabolife, and Willow bark OTC AND PRESCRIPTION MEDICATION
Both prescription and nonprescription medications need to be evaluated during the preoperative evaluation. There are some
medications that can complicate surgery as well as the healing process. It is very important to consult with your health care
professional about the OTC and prescription medications that you are currently taking. Remember to read all product labels or
package inserts, especially OTC preparations, in order to identify ingredients that may be potentially harmful. The following
medications can cause surgical complications. Recommended discontinuation times have been documented; however, NO
prescription medication should be stopped without the consent of your physician. No discontinuation time is
recommended for anticoagulation and other chronic prescription therapy.
ASPIRIN PRODUCTS – STOP TAKING 14 DAYS BEFORE SURGERY
ACETYLSALICYLIC ACID PRODUCTS –
Alka-Seltzer®, Anacin®, Arthritis Pain Formula®, Ascriptin®, Aspergum®, Pepto Bismol® ASPIRIN PRODUCTS –
Baby Aspirin, Bufferin®, Darvon Compound®, Ecotrin®, Empirin®, Equagesic®, Fiorinal®, 4-Way Cold®, Genprin®, Halfprin, Midol Max Stregth®, Norgesic®, Percodan®, Sine-Off®, Triaminicin Cold®, Vanquish®, Zorprin® *This is not an all-inclusive list*
NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)
IBUPROFEN PRODUCTS – STOP 1 DAY BEFORE SURGERY
Advil®, Bayer Select®, Excedrin IB®, Haltran®, Medipren®, Midol Cramp Formula®, Midol IB®, Motrin®, Nuprin®, DICLOFENAC, ETODOLAC, FLURBIPROFEN, KETOPROFEN, KETOROLAC, MECLOFENAMATE,
MEFENAMIC ACID, TOLMETIN PRODUCTS – STOP 2 DAYS BEFORE
Arthrotec®, Cataflam®, Voltaren®, Lodine®, Ansaid®, Orudis®, Toradol®, Ponstel®, Tolectin®, Tolectin DS® DIFLUNISAL, FENOPROFEN, INDOMETHACI
N, SULINDAC PRODUCTS—STOP 1 DAY BEFORE
Dolobid®, Nalfon®, Indocin®, Clinoril® MELOXICAM, NABUMETONE, NAPROXEN PRODUCTS – STOP 4 DAYS BEFORE
Mobic®, Relafen®, Aleve®, Anaprox®, Naprosyn® OXAPROZIN PRODUCT – STOP 12 DAYS BEFORE
PIROXICAM PRODUCT – STOP 14 DAYS BEFORE
ANTICOAGULANT THERAPY
MISCELLANEOUS MEDICATION
(Consult with physician about discontinuation time) Furosemide (Lasix®), Guaifenesin, Imipramine (Tofranil®), Nitrofurantoin (Macrobid®, Macrodantin®), Phenelzine (Nardil®), Tranylcypromine (Parnate®),Weight loss prescription Cilostazol (Pletal®) 2 days, Aggrenox® 14 days FOR CHRONIC PAIN CONDITIONS, THE FOLLOWING ARE ALTERNATIVES FOR PHYSICIANS
TO CONSIDER FOR PATIENT’S PAIN RELIEF PRIOR TO SURGERY:

ACETAMINOPHEN – and any other product that does not contain aspirin but contains acetaminophen such as:
Darvocet®, Excedrin PM®, Fioricet®, Midol Multi-Symptom Formula®, Midol Maximum Strength PMS Pamprin®,
Premsyn PMS®, Esgic®
NSAIDs – some NSAIDS AND COX 2 products do not cause bleeding problems, Arthropan®, Bextra®, Celebrex®,
Disalcid®, Doan’s®, Magsal®, Salsitab®, Trilisate®, Vioxx®,
OTHERS – Tramadol(Ultram®), Ultracet®, Darvon®
This is not an all exclusive list. Contact your local pharmacist if you have any questions about your medications.

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