Medicine use before surgery

Certain medicines can cause problems (complications) with your surgery unless you stop taking them before surgery.

Talk with your health care provider about all of the medicines you take (including over-the-counter medicines, herbals, vitamins or other supplements) at least 10 days before surgery. Ask your health care provider for instructions if you take a combination medicine that has any of the medicines in the chart.

Medicines not to take before surgery
Stop signImportant: These are general guidelines for medicines not to take before surgery. Your health care provider will tell you when to stop taking any medicines before surgery. Follow all instructions you receive from your health care provider.
Type of medicine Brand name examples Generic name examples General guidelines
Blood thinner medicine Ecotrin® or Bufferin® aspirin Stop taking this medicine 7 days before surgery, unless you have heart disease or peripheral vascular disease, or have had a stroke. Talk with your health care provider before stopping this medicine.
Plavix® clopidogrel Stop taking this medicine 7 days before surgery. Make sure to discuss this with your health care provider before you stop taking it.
Coumadin® or Jantoven® warfarin Stop taking this medicine 5 days before surgery. Talk with your health care provider who manages your warfarin before you stop taking your medicine. You may need to take other medicines when you are not taking warfarin.
Effient® prasugrel Stop taking this medicine 10 days before surgery. Make sure to discuss this with your health care provider before you stop taking it.
Brilinta® ticagrelor Stop taking this medicine 7 days before surgery. Make sure to discuss this with your health care provider before you stop taking it.
Pradaxa® dabigatran etexilate Stop taking this medicine 4 to 7 days before surgery. Make sure to discuss this with your health care provider before you stop taking it.
Savaysa® edoxaban Stop taking these medicines 1 to 4 days before surgery. Make sure to discuss this with your health care provider before you stop taking it.
Xarelto® rivaroxiban
Eliquis® apixaban
Over-the-counter and prescription nonsteroidal and anti-inflammatory (NSAID) medicine Motrin® or Advil® ibuprofen Stop taking this medicine 1 day before surgery. Talk with your health care provider before stopping this medicine.
Aleve® naproxen Stop taking this medicine 4 days before surgery. Talk with your health care provider before stopping this medicine.
Mobic® meloxicam Stop taking this medicine 5 days before surgery. Talk with your health care provider before stopping this medicine.
Voltaren® diclofenac sodium Stop taking this medicine 1 day before surgery. Talk with your health care provider before stopping this medicine.
Celebrex® celecoxib Stop taking these medicines 11 days before surgery. Talk with your health care provider before stopping this medicine.
Indocin® indomethacin
Blood glucose medicine Micronase® glyburide Talk with your health care provider who manages your diabetes before you stop taking your medicine. You may have other instructions.
Glucotrol® glipizide
Amaryl® glimepiride
Glucophage® metformin
Insulin insulin
Blood pressure medicine Zestril® or Prinivil® lisinopril Do not take any of the listed blood pressure medicines the morning of surgery. Talk with your health care provider before stopping this medicine.
Vasotec® enalarpil
Capoten® captopril
Altace® ramipril
Lotensin® benazepril
Cozaar® losartan
Diovan® valsartan
Avapro® irbesartan
Atacand® candesartan
HCTZ® hydro- chlorthiazide
Thalitone® chlorthalidone
Lasix® furosemide
Herbal products, vitamins or minerals     Stop taking any herbal supplement, product, vitamin or mineral 14 days before surgery.
Disease-modifying antirheumatic (DMARD) medicine Rheumatrex® or Trexall® methotrexate

Talk with your health care provider 4 to 6 weeks before your surgery about when you should stop taking DMARDs.

In general, most people stop taking DMARDs 1 to 2 weeks before surgery.

Enbrel® etanercept
Humira® adalimumab
Remicade® infliximab
Imuran® azathioprine
Arava® leflunomide
Simponi® golimumab

Medicines to keep taking before surgery

It is important to take certain medicines the morning of surgery.

If you take any of the medicines on the following list, take your morning dose with a small sip of water before you go to the hospital.

  • beta blockers such as atenolol (Tenormin®), carvedilol (Coreg®) or metoprolol (Lopressor®)
  • any heart medicine such as anti-arrhythmics or calcium channel blockers like diltiazem (Cardizem®, Dilacor XR®), verapamil (Calan®, Isoptin®, Verelan®) or amlodipine (Norvasc®)
  • asthma medicine (including an inhaler, steroids or both)
  • acid reflux medicine
  • pain medicine if needed
  • seizure medicine

Follow any instructions your health care provider gives you.

Source: Allina Health's Patient Education Department, Knee Replacement, fifth edition, ortho-ah-90140
First Published: 10/01/2000
Last Reviewed: 05/26/2017

Important

Do not take aspirin or medicines that contain aspirin before surgery.

If you take aspirin on a regular basis, talk with your health care provider about when to stop taking it.

Important

Tell your health care team which medicines you took the morning of surgery and what time you took them.