Medicines to tell us about before surgery
Some medicines affect bleeding, anaesthesia or blood sugar around surgery. Bring a complete list to your pre-operative appointment, including medicines, inhalers, herbal remedies and supplements.
Do not stop anything on your own
Nothing on this page is an instruction to stop a medicine. Some are genuinely dangerous to stop suddenly. Bring the list to your appointment and we will tell you what to do with each one, and when.
Blood thinners
These matter most, because they affect bleeding during and after surgery. They include warfarin, clopidogrel, the newer agents such as apixaban and rivaroxaban, and aspirin taken for the heart.
Many are stopped for a set number of days before surgery, and some are replaced with a short-acting alternative in the meantime. That plan has to be made with the doctor who prescribed it, which is why we need to know early rather than the night before.
Painkillers and anti-inflammatories
Tell the team which painkillers and anti-inflammatory medicines you use, including those bought without a prescription. Ask for a written plan covering what to take before and after surgery; do not change medicines on your own.
If you have been taking anti-inflammatories daily for months, say so. Long-term use affects the stomach and the kidneys, and both matter around an operation.
Diabetes medicines and insulin
Ask your diabetes clinician and anaesthetic team for a medicine and blood-sugar monitoring plan for the fasting period and recovery. The plan depends on the medicines you use and your health. Bring your recent blood sugar readings and your HbA1c if you have one.
Well-controlled diabetes is important here for a specific reason: high blood sugar raises the risk of wound infection, and an infection in a joint replacement is a serious complication.
Blood pressure and heart medicines
Bring the names and doses of your heart and blood-pressure medicines. Ask the team to record which medicines you should take on the day of surgery, including the timing and any instructions about water.
Steroids
If you take steroid tablets regularly, or have had a course recently, tell us. The team needs this information to plan your care. Do not stop steroid treatment without instructions from your clinician.
Herbal remedies and supplements
These are the ones patients leave off the list, because they do not feel like medicines. Include vitamins, herbal products and ayurvedic preparations in your medicine list. The team can check possible interactions and advise you individually.
Bring the packets. It is far easier for us to read the ingredients than for you to remember them.
The simplest way to do this
Put everything you take into a bag – prescription medicines, tablets from the chemist, supplements, herbal preparations, inhalers, eye drops – and bring the bag. It takes two minutes in clinic and it removes the guesswork entirely.
Bring the bag
Everything you take, in its own packaging, to your pre-operative appointment.
