Medication & Supplements to Avoid (printout)

It is often best not to ingest any brand of aspirin, or any of the following aspirin containing, MAO inhibiting and seratonin drugs for 14 days prior to surgery and 14 days after surgery. Although some medications may be deemed safe for your consumption by your surgeon and anesthesiologist only (i.e. Prozac, Zoloft, etc.). Just let them know. Disclose EVERY medication, oil, supplement, suspension, etc. -- your life depends upon it. Aspirin and aspirin-containing products, as well as some supplements and "nutraceuticals" may inhibit blood clotting and cause difficulties during and after surgery. If you need an aspirin-free fever reducer and pain reliever, it is often suggested to take Tylenol, but be sure to ask your surgeon. Also, if you smoke, you shouldn't smoke at least 2 weeks prior and at least 2 weeks after your surgery date. Smoking significantly reduces the quality of blood circulation and impedes vascularization. This means difficulty in bringing much needed oxygen to your tissues for proper healing.

Aches-N-Pains, Actifed, Acuprin, Addaprin, Adprin - B Tablets, Adult Analgesic Pain Relievers, Advil, AK Spore - HC, Alka Seltzer, All Arthritis Medicines, Allergy Relief Medicines (A.R.M.), Alpha Omega (fish oil), Aluprin, Aleve, Amigesic Capsules, Amitriptyline, Anacin, Anacin Arthritis/P, Ansaid Tablets (generic brand of Ansaid is Flurbiprofen), Anodynos Tablets, Analval, Anaprox, Anaprox-DS, Anaproxen, Anaproxen Anodynos, Ansaid, APAC Improved, APC, Argesic Tablets, Arthra-G, Arthralgen Tablets, Arthritis Pain Formula, Arthritis Strength Bufferin, Arthropan, Arthropan Liquid, As-caff, Ascodeen, Ascriptin, Ascriptin AID tablets, Ascriptin with Codeine Tablets, ALL ASCRIPTIN PRODUCTS, Aspir-lox, Asperi-mox, Aspirbuf, Aspercin, Aspergum, Aspirin (of any kind), Aspirin Suppositories, Aspirin with Codeine, ASpirTab, Asprimox Tablets, Asproject, A.S.A. Tablets, A.S.A. Enseals, Axotal, Azdone Tablets

B-A-C Tablets, Bayer Aspirin, Bayer Children's Aspirin Tablets, Bayer Children's Cold Tablets, Bayer Timed-Release Aspirin Tablets, Bayer Select Pain Formula, BC Powder/Tablets, Bilberry Tablets, Brufen, Buf Tab, Buff-A-Comp, Buff-A Comp No.3 Tablets with codeine, Buffaprin, Buffasal, Bufferin, Bufferin 37%, Bufferin Arth, Bufferin X/S Butalbit, Buffets II, Buffex, Buffinol, Buropion, Buropion HCL, Butazolidin

C-Advil Cama, Cama Arthritis Pain Reliever, Cama Inlay Tabs, CataFlam Tablets, Carisoprodol Compoud Tablets, Cayenne, Cephalgesic, Cheracol Tablets, Children's Advil Suspension, Children's Aspirin, Children's Motrin Suspension, Chro,mium, Chromium Picolinate, Claritin, Clinoril, Concerta (for ADD/ADHD), Congespirin, Contac, Cope, Coricidin Tablets, Coricidin "D" Decongestant Tablets, Coricidin, Coricidin Demilets Tablets for Children, Coricidin Mediets Tablets for Children, Coumadin

Damason-P, Darvon, Darvon with ASA, Darvon Compound, Darvon Compound-65, Darvon w/Apspirin, Darvon-N with Apsirin, Dasin, Dipryridamole, Disalcid, Diurex, Doan's, Dolcn, Dolobid, Dolphirn #3 Tablets, Drinopehn, Dristan, Dristan Sinus, Duoprin-S Syrup, Duradyne Tablets

Vitamin E, E-aspirin, Easprin EC, Echinacea, Ecolrin, Ecotrin Tablets, EFFEXOR^® XR, Elavil, Emagrin, Empirin, Empirin with Codeine, Emprazil, Endodan Tablets, Epromate Tablets, Equagesic, Equazine-M, Excedrin, EFFEXOR^® XR (venlafaxine HCl) Extended-Release, ExPrazi

Feldene, Fenoprofen Tablets, Feverfew, Fiogesic Tablets, Fioricett, Fiorinal, Fiorinal with Codeine, Florgen PF, Fluoxetin, Flurbiprofen Tablets, 4 Way Cold Tablets

garlic (allium sativum) tabs & do not eat garlic excessively (some say not at all - but if you accidentally get some or have a little garlic toast, I am sure it's okay, it's more for garlic tablets), Genaced, Genacote, Gelpirin Tablets, Genprin, Gensan, Ghemnisym, Gingko, Ginbko Biloba, Gennin, Ginger, Gingko, Ginkobiloba, GNP aspirin, Goody's Headache Powder, Goody-s Extra Strength

Halfprin Tablets, Haltran, Heparin, Hydroxycut

IBU, IBU-Tab, Ibuprofen, Ibuprin, Ibuprohm, Indocin, Indochron E-R Capsules , Indomethacin Caspules, Indomethacin Suspension, Infantol Pill, Isollyl Improved Tablets & Capsules

J none available

Ketoprofen Capsules

Lanorinal, Licorice Root, Lodine, Lortab ASA

MAO inhibitors, Magan, Magnaprin, Magnasprin, Magsal, Marnal, Marthritic Tablets, Maximum Bayer Aspirin, Measurin, Meclomen, MecloFenamate Capsules, Medigistic-Plus, Medipren, Meditren, Melatonin, Menadol, Meprogesic Q, Micraninin, Midol/Midol 200, Midol Original, Midol PMS, Mobidin, Moblgesic, Momentum Back Ache Formula, Monogesic, Motrin, Motrin IB, Multi-Vitamin

Nalfon, Nardil, Nardilzine, Naprosyn, Neomycin, Neogesic, Norgesic, Norgesic Forte, Norwich Extra Strength Aspirin, Nov-naproxen, Nuprin, NyQuil/NyQuil P.M.

Orphenagesic, Orphenagesic Forte, Orudis, Oruvail Capsules, Oxycodine, Oxycodone

P-A-C, Pabalate-SF, Pabrin, Pacaps, Pain Reliever Tablets, Pamprin-IB, Panalgesic, Panodynes, Papaya, PediaProfen, Pedrazil, Percodan, Percodan Demi Tabs, Persantin, Persisrin, Persistin, PetoBismol, Phenaphen, Phenetron Compound, Piroxicam Capsules, Polymyxin, Ponstel Capsules, Presalin, Propoxyphene Compound, Propoxyphene Napsylate with Aspirin, Prozac

Quagesic, Quiet World Analgesic (sleeping aid), Quinine

Relafen Tablets, Rexolate, Rhinex, Robaxin, Robasisal, Roxiprin Tablets, Rufin, Robaxisal

S-A-C, Salabuff, Salatin. Saleto, Saleto 200, Saleto-400,600,800 Tablets, Salflex, Salicylamide, Salocol, Salsalate, Salsitab, Serzone, Sign Off Sinus Tablets, Sine Aid, Sine Off, SK-65 Compound Capsules, Soma Compound, Soma Compound with Codeine, St. Joh'ns Wort, St. Josephs Aspirin, St. Joseph Cold Tablets (for children), Stanback Analgesic, Stanback Powder, Sudafed, Sulindac Tablets, Supac, Synalogos Capsules, Synalgos-DC Capsules

*Also a diet low in sodium is beneficial before and after any surgery.

Talwin Compound, Tenol-Plus, Tolectin 200,600 Tablets, Tolectin DS Capsules, Tolmetin Tablets/Capsules, Toradol Injection/Tablets, Tr-Pain Tablets, Trilisate Tablets and Liquid, Trendar, Trental, Triaminicin Tablets, Tricosal tablets, Tri-Pain, Trigesic, Trilisate, Tusal

Ultrapin, Unipro, Ursinos Inlay Tablets

Valesin, Valtrex, Vanquish, Verin, Viro-Med Tablets, Vivarin, Voltaren

Warafin (Coumadin), Wellbutrin, Wesprin Buffered

none available

Yohimbe

Zactrin, Zoloft (Zoloft has anti-coagulant properties so just advise your anesthesiologist if you take it) Zorprin, Zyban

Plus any other aspirin containing medication, be it natural, prescription or over the counter. Alert your doctor of any medications or supplements you may be taking. Even natural supplements have their risks. Read below...

Echinacea

Other Supplements, Vitamins and Herbal Remedies
not to ingest and why...

I know many people may take herbal supplements and some can be very good for you but many are contraindicated with anesthesia or surgery in general. Some reasons why you may not wish to disclose your herbal supplement consumption information to your surgeon or anesthesiologist may be because you believe that since these supplements are over the counter (OTC) they must be safe to use. This isn't true -- many of these are contraindicated and can severally hurt you when used in conjunction with anesthesia, other medications or while undergoing surgery. You may also think that because these products are from plants, therefore "natural," and cannot be dangerous -- many medications and dangerous drugs or even poisons are from plants, as well. So, please remember this. You may also think that telling your surgeon or anesthesiologist would be embarrassing, especially if you shouldn't be taking them, if you are taking them for weight loss, to increase your sexual stamina, or for acne or for depression. Nothing is embarrassing when it comes to safety. This is your life -- don't mess around!

Vitamin E is usually the #1 no-no. Vitamin E has anti-platelet properties and inhibits vital clot formation. Your surgeon may more than likely ask you to cease consuming Vitamin E in any form at least 2 to 3 weeks prior to any surgery and for 2 to 3 weeks afterwards. However, some surgeons recommend consumption at 2 weeks post-operatively for scar management and to help ward off capsular contracture in breast augmentation surgeries. Always follow your own surgeon's instructions.
Garlic (allium sativum), Ginger, Alfalfa, Cayenne, Papaya, Feverfew, Chamomile, Dong Quai root, Willow bark, Goldenseal, Guarana, Horse Chestnut and Bilberry Tablets/Supplements also have anti-platelet properties and may inhibit vital clot formation. These medications are normally taken to remedy edema (fluid retention). Some surgeons may give the okay for consumption of these supplements 2 to 3 weeks post-operatively.
Gingko, Gingko biloba, & Selenium are powerful anti-coagulants. It is considered to be 3 times stronger than Vitamin E.
Ginseng may cause rapid heartbeat/and or high blood pressure in some individuals as well as coagulation disruption.
St. John's Wort, Yohimbe, ("The natural Viagra®") and Licorice root have a mild monoamine oxidase (MAO) inhibitory effect and may intensify the effects of anesthesia. (*note some well known and popular anti-depressants are MAO inhibitors, disclose any and all medications you are taking -- your life may depend on it)
Melatonin decreases the amount of anesthesia needed for surgery.
Kava Kava, Hawthorn, Lemon verbena, Muwort, Lavender and Valerian/Valerian Root: (taken to promote relaxation and sleep) have tranquilizing properties and should not be combined with other sedative agents. WARNING! Tell your anesthesiologist/surgeon if you take either one of these.
Echinacea may have a severe impact on the liver when general anesthesia is used. Please advise your surgeon of all medications and supplements and alert him to the possible effects of herbal supplements and remedies, he may not be aware of the contraindications. It also has some coagulation disruption properties.
Ma Huang (aka Ephedra): Used by many people for weight loss and is a major component of most weight loss supplements) has been associated with more than 800 adverse health effects including DEATH. It is an amphetamine-like compound with the potential for stimulating the central nervous system and heart.
WARNING! we strongly discourage the use of this supplement in any form."In large doses ephedrine causes nervousness, headaches, insomnia, dizziness, palpitations, skin flushing, tingling and vomiting (Lawrence Review, 1989). The Handbook of Nonprescription Drugs notes that "The principal adverse effects of ephedrine are CNS stimulation, nausea, tremors, tachycardia [rapid heartbeat], and urinary retention." (APhA 1986).
Gotu Kola has a stimulant effect as well.
Ackee fruit as well as, Alfalfa, Aloe, Argimony, Barley, Bitter melon, Burdock root, Carrot oil, Chromium, Coriander, Dandelion root, Devil's club, Eucalyptus, Fenugreek seeds, Fo-ti, Garlic, Ginseng, Grape seed, Guayusa, Gmena, Juniper, Nem seed oil, Onions, Periwinkle, Yellow root alter the blood glucose level.
Garlic and Onions as a food: Even moderate consumption of onions and garlic can affect the body negatively when the body undergoes surgery. Try to limit your consumption for 2 weeks beforehand.

Special Medication Alerts!

If you are on Anti-depressants, please advise your doctor. Some monoamine oxidase (MAO) inhibitors (also known as MAOI) intensify the effects of the anesthesia -- especially General. This could be quite dangerous in the operating room if your doctor is unaware of your medication usage. If you advise your doctor or anesthesiologist he or she can make adjustments for your anesthesia or at least will watch for the slightest decrease or increase in heart or breathing rate.

These medications may include: Isocarboxazid, Marplan, phenelzine (Nardil, Nardelzine) tranylcypromine (Parnate, Sicoton), Deprenyl, selegiline hydrochloride, 5 HTP, Amitriptyline, Prozac, Wellbutrin, Buropion, Buropion HCL, Fluoxetin, EFFEXOR^® XR, etc.. They are used for the treatment of depression, obsessive-compulsive disorder, eating disorders, essential hypertension (pargyline), chronic pain syndromes, and migraine headaches. They work by inhibiting nerve transmissions in brain that may cause depression. Tranylcypromine and phenelzine account for over 90% of all MAO inhibitors currently prescribed.

It is reported that drug interactions can occur even weeks after discontinued use of an MAOI. Therefore, in patients undergoing General anesthesia, cessation of usage is normally instructed several weeks prior to surgery to avoid possible cardiovascular effects.

"Anesthetic Requirements: Anesthetic requirements are increased, reflecting accumulation of norepinephrine in the CNS." Ref: Stoelting, R.K, Pharmacology & Physiology in Anesthetic Practice, pp. 378-381.