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Medicine you should stop taking before knee replacement surgery

Blood thinner medicines

If you are taking some kind of blood thinner medicine, call your doctor to find out if or when your medicine should be stopped before surgery.

Examples of medicines that can thin your blood are: aspirin, warfarin (Coumadin®), Plavix®, heparin, Lovenox® or Arixtra.™

Herbal medicines

Herbal or natural medicines can cause side effects or interfere with other medicines. You should check with your doctor to see if any herbal medicines you are taking need to be stopped before surgery.

There are 13 commonly used herbals that have some known side effects that may occur when taken with other medicines. Check with your doctor if you are taking:

St. John's wort

echinacea

ginkgo (ginkgo biloba)

ephedra (ma-huang)

ginseng

licorice

garlic

valerian

ginger

feverfew

saw palmetto

goldenseal

kava-kava


Pain medicines

You should stop taking the following pain medicines before surgery.

Type of pain medicine (non-steriodal anti-inflammatory agent)

Brand name example

Number of days to stop taking before surgery (2 to 7)

diclofenacCataflam®, Voltaren®2
diflunisalDolobid®7
etodolacLodine®2
fenoprofenNalfon®2
flurbiprofenAnsaid®2
ibuprofenAdvil®, Motrin®, Nuprin®2
indomethacinIndocin®2
ketoprofenOrudis®, Oruvail®2
ketorolacToradol®2
meclofenamate2
mefenamic acidPonstel®2
nabumetone (more than 1,000 mg a day)Relafen®4
naproxenAnaprox®, Naprosyn®, Naprelan®2
oxaprozinDaypro®4
piroxicamFeldene®4
sulindacClinoril®2
tolmetinTolectin®2

Check your medicine(s) to see if they contain any of those listed above. Ask your pharmacist if you should stop taking any combination medicine that includes any of those listed above.

The list does not include all medicines you may be taking. If you do not see your medicine(s), ask your pharmacist if you should stop taking your medicine(s). Check with your doctor or surgeon if you are taking any medicines for non-pain management reasons (such as amitriptyline for depression).

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Source: Allina Patient Education, Total Knee Replacement, third edition, ortho-ahc-90140

First published: 10/01/2000
Last updated: 12/01/2006

Reviewed by: Allina Patient Education experts