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Medications Before Surgery

This page explains, in general terms, the kinds of medicines and supplements that are sometimes paused before a procedure. It is not personal instructions. Do not stop or change any medication unless your care team told you to. If you take one of these and did not receive instructions before your procedure, call the office.

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How to use this page

Some medicines and supplements are sometimes paused before a procedure, most often because they can raise the risk of bleeding or affect anesthesia. This page is general awareness only. It is not a list of what to stop, and it is not advice about your medicines.

Whether to hold a medicine — and for how long — depends on the medicine, the procedure, and your health. Only your care team can make that call, sometimes together with the doctor who prescribed it.

Bring a full list of everything you take to your appointments — prescriptions, over-the-counter medicines, vitamins, and supplements. That is the best way to get the right instructions.

Blood thinners and antiplatelet medicines

These reduce clotting, which can mean more bleeding during and after a procedure. Common examples:

warfarin (Coumadin)
apixaban (Eliquis), rivaroxaban (Xarelto), dabigatran (Pradaxa), edoxaban (Savaysa)
clopidogrel (Plavix), prasugrel (Effient), ticagrelor (Brilinta)
aspirin (including low-dose “baby” aspirin)

Never stop a blood thinner on your own. Some are protecting a heart stent, valve, or clot, and stopping them can be dangerous. Your care team will coordinate with your prescriber if a change is needed.

GLP-1 and GIP injectables (diabetes / weight)

These slow how fast the stomach empties, which can matter for anesthesia and sedation. Common examples:

semaglutide (Ozempic, Wegovy, Rybelsus)
tirzepatide (Mounjaro, Zepbound)
dulaglutide (Trulicity), liraglutide (Victoza, Saxenda), exenatide (Byetta, Bydureon)

If you take one of these and will have sedation or anesthesia, ask whether it should be paused — but only change it if your care team tells you to.

SGLT2 inhibitors (diabetes)

These are sometimes paused for a few days before surgery because of a rare risk of a serious problem called ketoacidosis around the time of surgery. Common examples:

empagliflozin (Jardiance)
dapagliflozin (Farxiga)
canagliflozin (Invokana), ertugliflozin (Steglatro)

NSAIDs (anti-inflammatory pain relievers)

These can increase bleeding and are sometimes paused before a procedure. Common examples:

ibuprofen (Advil, Motrin)
naproxen (Aleve)
aspirin, meloxicam (Mobic), celecoxib (Celebrex), diclofenac

Acetaminophen (Tylenol) is a different kind of pain reliever — follow the instructions you were given about which pain relievers to use.

Supplements and herbals

Many supplements can thin the blood or interact with anesthesia and are often stopped before surgery. Common examples:

fish oil / omega-3
vitamin E
garlic, ginkgo, ginseng, ginger, turmeric/curcumin
other herbal products and “natural” blood-thinning supplements

Supplements count as medicines here. Include them on the list you bring to your appointment.

Read this first

The single most important message on this page:

Do not stop or change any medication on your own.
If you take any medicine or supplement and were not given instructions before your procedure, call the office number on your discharge paperwork.
Bring a complete list of everything you take to every appointment.

This page is general education, not instructions for you. When in doubt, call and ask before making any change.

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