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Medication Administration Prior to Surgery
There is often confusion regarding when to stop or resume medications before and after surgery. Please refer to the following general guidelines regarding any medications you may be taking. Please feel free to contact us for with any questions!
Medication | Stop Before Surgery (Days) | Start After Surgery (Days) | Comment |
|---|---|---|---|
Abciximab (ReoPro) | 12-24 hours | Varies | |
Apixaban (Eliquis) | 3 days | 48 hours | |
Apremilast (Otezla) | Not Necessary | Immediately | In high risk patients, can hold 3d before surgery |
Argatroban | 4 hours | 1 hour | Defer surgery until off medication unless urgent |
Aspirin | 5 days | 1 day | Does not need to be held for "minor" procedures |
Aspirin/Dipyrimadole (Aggrenox) | 5 days | 1 day | |
Azathiop | |||
Azathioprine | 1 week | Immediately | |
Bivalirudin (Angiomax) | 4 hours | 1 hour | Defer surgery until off medication unless urgent |
Celecoxib (Celebrex) | 2-3 days | Varies | |
Clopidogrel (Plavix) | 5 days | 1 day | |
Cyclosporine A | 1 week | 3-5 days | If disease is severe, can continue |
Dabigatran (Pradaxa) | 2-3 days | 48 hours | Defer surgery until off medication if possible. Wait 3-5 days if CrCl < 50mL/min |
Diclofenac | 24 hours | Varies | |
Difunisal | 2-3 days | Varies | |
Eptifibatide (Integrilin) | 4 hours | Varies | |
Fondaparinux (Arixtra) | 2-3 days | 6 hours | If CrCl < 50mL/min, hold 3-5 days before surgery |
Heparin | 2-4 hours | 1 hour | aPTT < 1.5x control |
Hydroxychloroquine | Not necessary | Immediately | |
Ibuprofen (Advil, Motrin) | 7 | TBD | |
Ibuprofen (Advil, Motrin) | 24 hours | Varies | Half-life 2-6 hours |
Indomethacin | 24 hours | Varies | |
Ketoprofen | 24 hours | Varies | |
Leflunomide | Not necessary | ||
Low Molecular Weight Heparin (Lovenox) | 12 hours | 6 hours | If high bleeding risk, held for 24 hours prior to surgery |
Meloxicam (Mobic) | 10 days | Varies | Half-life > 20 hrs |
Methotrexate | Not necessary | Immediately | null |
Mofetil | 1 week | 3-5 days | If disease is severe, can continue |
Mycophenolate | 1 week | 3-5 days | If disease is severe, can continue |
Nabumetone | 10 days | Varies | |
Naprosyn (Aleve) | 7 | ||
Naproxen (Naprosyn) | 2-3 days | Varies | Half-life 7-15 hours |
Piroxicam | 10 days | Varies | |
Prasugrel (Effient) | 5 days | 1 day | |
Rivaroxaban (Xarelto) | 2-3 days | 48 hours | If CrCl < 50mL/min, hold 3-5 days |
Sulfasalazine | Not necessary | Immediately | |
Sulindac | 2-3 days | Varies | |
Tacrolimus | 1 week | 3-5 dyas | If disease is severe, can continue |
Tafacitinib | 1 week | 14 days | |
Ticagrelor (Brilinta) | 5 days | Immediately | |
Ticlopidine (Ticlid) | 7 days | 1 day | |
Tirofiban (Aggrastat) | 4 hours | Varies | |
Vitamins, herbs, dietary supplements | 10 | 7 | |
Warfarin (Coumadin) | 5 days | 12-24 hours | Can be held 3d prior to "minor" procedures, |