Nowadays, many patients are taking nutritional supplements in increasing amounts. While generally beneficial and safe, their use around the time of surgery may not be desirable. Certain nutritional supplements may cause adverse reactions during or after surgery, including prolonged bleeding, interference with anesthesia, cardiovascular disturbances, and interactions with prescription drugs.
To ensure surgical safety, please discontinue the use of the following nutritional supplements two weeks prior to surgery and two weeks after surgery:
To date, there have been few systematic examinations of the effects of dietary supplements when taken with prescribed anti-thrombotic (anticoagulant or anti-platelet) therapies. According to the Natural Medicines Comprehensive Database, approximately 180 dietary supplements have the potential to interact with warfarin, a common blood thinner, and more than 120 may interact with aspirin and other anti-platelet agents, such as clopidogrel, ticlopidine, and dipyridamole. Dietary supplements include herbal remedies, vitamins, minerals, other botanical products, fibers, amino acids, proteins, organ tissues, and metabolites for digestion.
Known interactions with prescribed anti-coagulants and their effects include:
It is often best not to ingest any brand of aspirin or any of the following aspirin containing MAO inhibiting and serotonin 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 suggested to take Tylenol. 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.
A Accutrim, Acetidine, Acetilsalicylic Acid, Aches-N-Pains, Actifed, Actron, Acuprin, Adapin, Addaprin, Adipex, Adprin- B Tablets, Adult Analgesic Pain Relievers, Advil, AK Spore – HC, Aggrenox, Alka Seltzer, All Arthritis Medicines, Allergy Relief Medicines (A.R.M.), Alpha Omega (fish oil), Aluprin, Aleve, Amigesic Argesic-5A, Amigesic Capsules, Amitriptyline, Amoxapine, Anacin, Anacin Arthritis/P, Anafranil, Anahist, Ansaid Tablets (generic brand of Ansaid is Flurbiprofen), Anodynos Tablets, Analval, Anaprox, Anaprox-DS, Anaproxen, Anaproxen Anodynos, Anexia, Anisidione, Ansaid, Anturane, 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, Ascription, Asendin, Aspir-lox, Asperi-mox, Aspirbuf, Aspercin, Aspergum, Asprimox products, Aspirin (of any kind), Aspirin Suppositories, Aspirin with Codeine, ASpirTab, Asprimox Tablets, Asproject, A.S.A. Tablets, A.S.A. Enseals, Aventyl, Axotal, Azdone Tablets, Azulfidine B B-A-C Tablets, Backache Maximum Strength, Bayer Aspirin, Bayer Children’s Aspirin Tablets, Bayer Children’s Cold Tablets, Bayer Timed-Release Aspirin Tablets, Bayer Select Pain Formula, BC Powder/Tablets, Bextra, BextraBilberry Tablets, Bocadren, Bromo-seltzer, Bromo-quinine, 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 C-Advil Cama, Cama Arthritis Pain Reliever, Cama Inlay Tabs, CataFlam Tablets, Carisoprodol Compoud Tablets, Cartol, Cayenne, Celebrex, Cephalgesic, Cheracol Tablets, Children’s Advil Suspension, Children’s Aspirin, Children’s Motrin Suspension, Choline, Chromium, Chromium Picolinate, Claritin, Clinoril, Clinoril C, Clomipramine, Concerta (for ADD/ADHD), Condroitin, Congespirin, Contac, Cope, Corgard, Coricidin Tablets, Coricidin “D” Decongestant Tablets, Coricidin, Coricidin Demilets Tablets for Children, Coricidin Mediets Tablets for Children, Corididin, Cortisone, Coumadin D Dalteparin Inj., Damason-P, Darvon, Darvon with ASA, Darvon Compound, Darvon Compound-65, Darvon w/Apspirin, Darvon-N with Apsirin, Dasin, Desipramine, Dipryridamole, Disalcid, Choline, Diurex, Doan’s, Dolcn, Dolobid, Dolphirn #3 Tablets, Doxepin, Drinopehn, Dristan, Dristan Sinus, Duoprin-S Syrup, Duragesic, Duradyne Tablets E Vitamin E, E-aspirin, Easprin EC, Echinacea, Ecolrin, Ecotrin Tablets, EFFEXOR® XR, Elavil, Emagrin, Empirin, Empirin with Codeine, Emprazil, Endodan Tablets, Enoxaparin, Epromate Tablets, Enteric, Ephedra, Equagesic, Equazine-M, Etafon Products, Excedrin, EFFEXOR® XR (venlafaxine HCl) Extended-Release, ExPrazi F Feldene, Fenoprofen Tablets, Fenphen, Feverfew, Fiogesic Tablets, Fioricett, Fiorinal, Fiorinal with Codeine, Fish Oil, Flagyl, Florgen PF, Fluoxetin, Flurbiprofen Tablets, Fragmin, Furadantin, 4 Way Cold Tablets, 5-Aminoslicylic Acid G 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, Ginseng, Glucosamine, GNP aspirin, Goldenseal, Goody’s Headache Powder, Goody-s Extra Strength H Halfprin Tablets, Haltran, Heparin, Hismanal, Hydroxycut, Hydrocortisone I IBU, IBU-Tab, Ibuprofen, Ibuprin, Ibuprohm, Imipramine, Inderal, Inderide, Indocin, Indochron E-R Capsules , Indomethacin Caspules, Indomethacin Suspension, Infantol Pill, Inhiston, Isollyl Improved Tablets & Capsules J Janimine K Kava, Ketoprofen Capsules L Lanorinal, Levatol, Licorice Root, Limbitol, Liquinprin, Lodine, Lortab ASA, Lovenox Inj., Ludiomil M MAO inhibitors, Macrodantin, Magan, Magnaprin, Magnasprin, Magsal, Maprotiline, Marnal, Marthritic Tablets, Maximum Bayer Aspirin, Measurin, Meclomen, MecloFenamate Capsules, Medigistic-Plus, Medipren, Meditren, Melatonin, Mellaril, Menadol, Meprogesic Q, Micraninin, Midol/Midol 200, Midol Original, Midol PMS, Milk Thistle, Miradon, Mobidin, Mobic, Moblgesic, Momentum Back Ache Formula, Monogesic, Motrin, Motrin IB, Multi-Vitamin N Nalfon, Nardil, Nardilzine, Naprosyn, Neomycin, Neogesic, Norgesic, Norgesic Forte, Nortryptyline, Norwich Extra Strength Aspirin, Nov-naproxen, Nuprin, NyQuil/NyQuil P.M. O Orphenagesic, Orphenagesic Forte, Orudis, Oruvail Capsules, Oxycodine, Oxycodone P P-A-C, Pabalate-SF, Pabrin, Pacaps, Pain Reliever Tablets, Pamprin-IB, Panalgesic, Panodynes, Papaya, PediaProfen, Pedrazil, Pentasa, Pepto-Bismol, Percodan, Percodan Demi Tabs, Persantin, Persisin, Persistin, Pertofrane, PetoBismol, Phenaphen, Phenetron Compound, Phenylpropanilamine Pondimin (Fenfluramine), Piroxicam Capsules, Polymyxin, Ponstel Capsules, Prednisone, Presalin, Propanolol, Propulsid, Propoxyphene, Propoxyphene Compound, Propoxyphene Napsylate with Aspirin, Protamine, Prozac, Pyrroxate Q Quagesic, Quiet World Analgesic (sleeping aid), Quinine R Redux (Dexenfluramine), Relafen Tablets, Rexolate, Rhinex, Robaxin, Robasisal, Robaxisal, Roxiprin Tablets, Ru-Tuss, Rufin, S S-A-C, Sal-Sayne, Salabuff, Salatin. Saleto, Saleto 200, Saleto-400,600,800 Tablets, Salflex, Salicylamide, Salocol, Salsalate, Salsitab, Saw Palmetto, Seldane, Serzone, Sign Off Sinus Tablets, Sine Aid, Sine Off, Sinex, SK-65 Compound Capsules, Sofarin, Soltice, Soma Compound, Soma Compound with Codeine, St. John’s Wort, St. Josephs Aspirin, St. Joseph Cold Tablets (for children), Stanback Analgesic, Stanback Powder, Sudafed, Sulindac Tablets, Supac, Surmontin, Surmontil, Synalogos Capsules, Synalgos-DC Capsules T Talwin Compound, Tenol-Plus, Tenuate Dospan, Theracin, Thorazine, Ticlid, Ticlopidine, Tolectin 200,600 Tablets, Tolectin DS Capsules, Tolmetin Tablets/Capsules, Toradol Injection/Tablets, Tr-Pain Tablets, Tri-Pain, Trental, Triavil, Tricosal tablets, Trigesic, Trigestic, Trilisate, Trilisate Tablets and Liquid, Tusal U Ultrapin, Unipro, Ursinis, Ursinos Inlay Tablets V Valerian, Valesin, Valtrex, Vanquish, Verin, Vibramycin, Vicoprofen, Vioxx, Viro- Med Tablets, Visken, Vitamin-E, Vivactil, Vivarin, Voltaren W Warfarin (Coumadin), Wellbutrin, Wesprin Buffered Y Yohimbe Z Zactrin, Zoloft (Zoloft has anti-coagulant properties so just advise your anesthesiologist if you take it) Zorprin, Zyban
*Also a diet low in sodium is beneficial before and after any surgery. 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. Please read below.
I know many people may take herbal supplements. Some can be very good for you, but many are contraindicated with anesthesia or surgery in general. Since these supplements are over-the-counter and generally safe to use, some patients might forget to disclose their consumption to their surgeon and anesthesiologist. Many of these are contraindicated and can severely hurt you when used in conjunction with anesthesia, other medications, or while undergoing surgery. Furthermore, just because these products are derived from plants and are considered “natural,” many medications and drugs are actually considered dangerous. Please keep this important point in mind: while you may be embarrassed to disclose your use of medications for weight loss, sexual performance, or depression, don’t be. Nothing is embarrassing when it comes to safety. This is your life – be truthful with us!
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, Bupropion, 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 the 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.
If you have any questions about medications or supplements to discontinue prior to a procedure or surgery, please contact our office.
Under the direction of visionary double board-certified facial plastic surgeon Dr. Roberto Garcia, Contoura Facial Plastic Surgery offers the latest surgical and non-surgical procedures in a relaxed and serene setting. Schedule a virtual or in-person consultation today to get the first glimpse of your future self.
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