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Medications to Stop Before Surgery

Important Instructions for Patients

 

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What You Need to Know

This list might not cover all medications or reasons for taking them. If you have any questions, feel free to reach out to your primary care provider for clarification.

When stopping medications, remember to count the day of your procedure as the last day to hold. For example, if you're instructed to stop your medication 3 days before surgery and your procedure is on a Monday, your last dose would be on the Friday before.

To view this list as a PDF, click here. 

If you have any questions, please contact Waukee Surgery Center at 515.875.8000.

Anticoagulants/Antiplatelets

The follow medications, usually taken to keep blood from clotting, is to be stopped as instructed by YOUR prescribing physician (either cardiologist or primary care).

If not told to stop, call surgeon’s office for directions.

Aggrastat/Tirofiban
STOP 4-8 hrs before surgery 
Dalteparin/Fragmin
STOP 12-24 hrs before surgery 
If unsure, contact your surgeon's office.
 
Eptifibatide/Integrilin
STOP 4-8 hrs before surgery 
Apixaban/Eliquis
STOP 3 days before surgery 
Dipyridamole
/Persantine
STOP 1 day before surgery 
Fondaparinux/Arixtra
STOP 2-3 days before surgery 
Aspirin Dipyridamole /Aggrenox
STOP 7 days before surgery 
Edoxaban/Savaysa
STOP 3 days before surgery
Pentoxyfylline/Trental
STOP 5 days before surgery
 
Cilostazol/Pletal
STOP 2 days before surgery 
Effient/Prasugrel
STOP 7 days before surgery
Rivaroxaban/Xarelto
STOP 3 days before surgery 
 
Clopidogrel/Plavix
STOP 7 days before surgery 
Elmiron/Pentosan
STOP 5 days before surgery
Ticagrelor/Brilinta
STOP 7 days before surgery 
 
Coumadin/Warfarin
/Jantoven
STOP 5 days before surgery 
Enoxaparin/Lovenox
STOP 12-24 hrs before surgery
If unsure, contact your surgeon's office. 
Ticlodipine/Ticlid
STOP 10 days before surgery 
 
Dabigatran/Pradaxa
STOP 5 days before surgery 

 

 

 

 

Tumor Necrosis Factor Blocker TNF Blockers/Inhibitors

Usually taken for Crohn’s Disease, Ulcerative Colitis, Rheumatoid Arthritis, Spondylitis, Psoriatic Arthritis & Plaque Psoriasis.

Adalimumab, Enbrel, Etanercept & Humira
 
Stop 14 days before surgery- if not instructed to stop by surgeon, ask surgeon’s office

Selective Estrogen Receptor Modulators
SERMs

Usually used for Breast Cancer, Osteoporosis.

Evista & Raloxifene                                                                                     
 
Stop 3 days before surgery                                                                        
Nolvadex, Soltamox & Tamoxifen
 
Stop 14 days prior to surgery

Medications with Phentermine.

Usually taken for weight loss.

Adipex-P, Belviq, Bontril, Fastin, Lomaira, Phentermine, Topiramate, Qsymia, Contrave, Suprenza, etc.
 
Stop 7 days before surgery.

Weight Loss Medication Not Containing Phentermine

Taken for weight loss.

Contrave, Naltrexone, Bupropion, etc.Stop 3 days before surgery.
Diethylpropion, Tenuate
 
Stop 2 days before surgery.

Glucagon-like Peptide 1 Receptor Agonists 
GLP-1s (WHEN TAKEN ONCE WEEKLY)

Usually used for weight loss.

Dlyxin, Albiglutide, Bydureon/BCise, Byetta, Dulaglutide, Exenatide ER, Liraglutide, Lixisenatide, Mounjaro, Ozempic, Pramlintide, Rybelsus, Semaglutide ER weekly dosing, Symlin, Tanzeum, Tirzepatide, Trulicity, Wegovy, etc.
 
Stop 7 days before surgery

Antineoplastics

Usually taken for certain cancers.

Hydroxyurea
 
Stop 5 days before surgery- if not instructed to stop by surgeon, ask surgeon’s office

Sodium Glucose Co-transporter-2 Inhibitors 
SGLT2is

Usually taken for diabetes.

Bexagliflozin, Brenzavvy, Canagliflozin, Dapagliflozin, Empagliflozin, Farxiga, Invokana, Jardiance, etc.
 
Stop 3 days before surgery
Ertugliflozin and Steglatro, etc.
 
Stop 4 days before surgery

Glucagon-like Peptide Agonists

WHEN TAKEN DAILY OR TWICE DAILY

Usually taken for Diabetes and/or weight loss.

Byetta, Exenatide IR twice daily dosing, Liraglutide daily dosing, Rybelsus, Saxenda, Semaglutide IR daily dosing, Victoza, etc.
 
Stop 24 hours before surgery

Phosphodiesterase Inhibitors

Usually taken for erectile dysfunciton.

Avanafil, Cialis, Levitra, Sildenafil, Stendra, Tadalafil, Vardenafil, Viagra, etc.
 
Stop 3 days before surgery.

Janus Kinase Inhibitor 
JAK inhibitors

Usually taken for Rheumatoid Arthritis, Psoriatic Arthritis, Juvenile Arthritis, Spondyloarthritis, Ulcerative Colitis, Dermatitis & Alopecia.

Baricitinib, Olumiant, Rinvoq, Tofacitinib, Upadactinib, Xeljanz, etc.
 

Stop 3 days before surgery.

If not instructed to stop by surgeon, please contact your surgeon’s office

Opioid Antagonists

Usually taken for opioid abuse/alcohol abuse history.

Depade, Naloxone, 
Naltrexone, Narcan, 
ReVia, Vivitrol, etc.
 
Stop 3 days before surgery.

Incretin Memetic

Usually taken to lower blood sugar.

Lixisenatide, Insulin Glargine,
Soliqua, etc.
 
Stop 24 hours before surgery.

Selective Serotonin Receptor Agonists 
SSRA

Usually taken for migraines.

Almotriptan, Amerge, Axert,
Eletriptan, Frova, Frovatriptan,
Imitrex, Maxalt, Naratriptan,
Relpax, Rizatriptan, Sumatriptan,
Zolmitriptan, Zomig, etc.
 
Stop 24 hours before surgery

Cholinesterase Inhibitors

Usually used for Alzheimer’s Disease or Dementia.

Exelon, Rivastigmine, etc.                                                                                    
 
Stop 24 hours before surgery                                                             

Marijuana

Recreational, Oils, Gummies, 
Edible, etc.                                                                                     
 
Stop 24 hours before surgery

Insulins

Do NOT take sliding scale insulin or quick-acting insulin the day of surgery.

 

Long-Acting Insulin or Insulin Pump

Check with your doctor that prescribes the Insulin regarding the dosage the day/night before surgery.
 


Non-Steroidal Anti-Inflammatory Drugs NSAIDS

Usually used to relieve pain, reduce inflammation and/or bring down a high temperature.

Advil, Aleve, Aspir 81, Aspirin,
Celebrex, Celecoxib, Diclofenac,
Diflunisal, Ecotrin, Etodolac,
Ibuprofen, Ketorolac, Meloxicam,
Mobic, Motrin, Nabumetone,
Naprosyn, Naproxen, Toradol,
Voltaren, etc.                                                                                                                                  
 
Stop as instructed by surgeon.                                                                                    

 

Download Medications to Stop PDF here