Download this table of Supplements and Medication to Discontinue.
Supplements to discontinue during the preoperative period
Herb (other names)
Relevant effects
Perioperative concerns
Recommendations
Relevant effects
Perioperative concerns
Recommendations
Bilberry (vacciniummyrtillus)
Excellent antioxidant thatstrengthens Capillaries and collagen.
Contain anthocyanosides,favonoid compounds that improve visual acuity and are important in treatment of eye disorders. Has antiplatelet activity and may inhibit clot formation.
Discontinue use two weeksprior to surgery.
Excellent antioxidant thatstrengthens Capillaries and collagen.
Contain anthocyanosides,favonoid compounds that improve visual acuity and are important in treatment of eye disorders. Has antiplatelet activity and may inhibit clot formation.
Discontinue use two weeksprior to surgery.
Cayenne (capsicumannuum)
Used for GI tract disorders
Overdose may cause severehypothermia.
Discontinue use two weeksprior to surgery.
Used for GI tract disorders
Overdose may cause severehypothermia.
Discontinue use two weeksprior to surgery.
Dong Quai (angelica sinensis)
The main application is inthe relief of menstrual cramps. Used in menopausal symptoms.
Active constituent is coumarinderivatives, which may potentiate existing anticoagulant medications
Discontinue use two weeksprior to surgery.
The main application is inthe relief of menstrual cramps. Used in menopausal symptoms.
Active constituent is coumarinderivatives, which may potentiate existing anticoagulant medications
Discontinue use two weeksprior to surgery.
Echinacea
Boosts immunity
Allergic reactions, impairsimmune suppressive drugs, can cause immune suppression when taken long-term, could impair wound healing.
Discontinue as far in advanceas possible, especially for transplant patients or those with liver dysfunction.
Boosts immunity
Allergic reactions, impairsimmune suppressive drugs, can cause immune suppression when taken long-term, could impair wound healing.
Discontinue as far in advanceas possible, especially for transplant patients or those with liver dysfunction.
Ephedra (mahuang)
Increases heart rate,increases blood pressure
Risk of heart attack,arrhythmias, stroke, interaction with other drugs, kidney stones.
Risk of heart attack,arrhythmias, stroke, interaction with other drugs, kidney stones.
Increases heart rate,increases blood pressure
Risk of heart attack,arrhythmias, stroke, interaction with other drugs, kidney stones.
Risk of heart attack,arrhythmias, stroke, interaction with other drugs, kidney stones.
Feverfew (tanacetum paithenium)
Used for migraineheadache prevention as well as arthritis and allergies.
May increase bleeding,especially in patients taking certain anticlotting medications.
Discontinue use two weeksprior to surgery.
Used for migraineheadache prevention as well as arthritis and allergies.
May increase bleeding,especially in patients taking certain anticlotting medications.
Discontinue use two weeksprior to surgery.
Fish oil caplets
Important omega 6 fattyacid, DHA and EPA. Reduces cholesterol and triglyceride levels.
Has blood thinning properties.
Discontinue use two weeksprior to surgery.
Important omega 6 fattyacid, DHA and EPA. Reduces cholesterol and triglyceride levels.
Has blood thinning properties.
Discontinue use two weeksprior to surgery.
Garlic (ajo)
Prevents clotting
Risk of bleeding, especiallywhen combined with other drugs that inhibit clotting.
Discontinue at least 7 daysbefore surgery.
Prevents clotting
Risk of bleeding, especiallywhen combined with other drugs that inhibit clotting.
Discontinue at least 7 daysbefore surgery.
Ginger (zingiberofficinale)
Useful as antispasmodic,anti-inflammatory, antinauseant. Prophylactic for motion sickness, stimulate appetite. Useful for postoperative emesis.
Use of ginger may alter bleedingtime. Ginger may interfere with cardiac and anticoagulant medications.
Discontinue use two weeksprior to surgery.
Useful as antispasmodic,anti-inflammatory, antinauseant. Prophylactic for motion sickness, stimulate appetite. Useful for postoperative emesis.
Use of ginger may alter bleedingtime. Ginger may interfere with cardiac and anticoagulant medications.
Discontinue use two weeksprior to surgery.
Ginko (duck foot,maidenhair, silver apricot)
Prevents clotting
Risk of bleeding, especiallywhen combined with other drugs that inhibit clotting.
Discontinue at least 36 hoursbefore surgery.
Prevents clotting
Risk of bleeding, especiallywhen combined with other drugs that inhibit clotting.
Discontinue at least 36 hoursbefore surgery.
Ginseng
Lowers blood glucose,inhibits clotting,
Lowers blood-sugar levels.Increases risk of bleeding. Interferes with warfarin (an anti-clotting drug).
Discontinue at least 7 daysbefore surgery.
Lowers blood glucose,inhibits clotting,
Lowers blood-sugar levels.Increases risk of bleeding. Interferes with warfarin (an anti-clotting drug).
Discontinue at least 7 daysbefore surgery.
Hawthorne (crategus laevigata)
Used for ability topotentiate the action of cardiac glycosides.
Potentiates the actions ofdigitalis and other cardiac glycosides.
Discontinue use two weeksprior to surgery.
Used for ability topotentiate the action of cardiac glycosides.
Potentiates the actions ofdigitalis and other cardiac glycosides.
Discontinue use two weeksprior to surgery.
Kava (kawa,awa,intoxicating pepper)
Sedates, decreases anxiety
May increase sedative effects ofanesthesia. Risks of addiction, tolerance and withdrawal unknown.
Discontinue at least 24 hoursbefore surgery.
Sedates, decreases anxiety
May increase sedative effects ofanesthesia. Risks of addiction, tolerance and withdrawal unknown.
Discontinue at least 24 hoursbefore surgery.
Licorice Root (glycyrrhiza Glabra)
Used for gastric, duodenalulcers, gastritis, cough/bronchitis.
Glycyrrhize acid may cause highblood pressure, hypokalemia and edema
Discontinue use two weeksprior to surgery.
Used for gastric, duodenalulcers, gastritis, cough/bronchitis.
Glycyrrhize acid may cause highblood pressure, hypokalemia and edema
Discontinue use two weeksprior to surgery.
Ma Huang (ephedra sinica)
Used in energy products &weight loss
More then 800 adversereactions reported to FDA. Causes hypertension, tachycardia, cardiomyopthy, dysrhythmias
Discontinue use two weeksprior to surgery.
Used in energy products &weight loss
More then 800 adversereactions reported to FDA. Causes hypertension, tachycardia, cardiomyopthy, dysrhythmias
Discontinue use two weeksprior to surgery.
Melatonin
Used for jet lag, insomnia &SAD
May potentiate CNS effects ofbarbiurates and general anesthesia
Discontinue use two weeksprior to surgery.
Used for jet lag, insomnia &SAD
May potentiate CNS effects ofbarbiurates and general anesthesia
Discontinue use two weeksprior to surgery.
Red Clover (trifloiupretense)
Used to relieve menopausalsymptoms
Active constituent includescoumarin derivatives, which may potentiate existing anticoagulant medications.
Discontinue use two weeksprior to surgery.
Used to relieve menopausalsymptoms
Active constituent includescoumarin derivatives, which may potentiate existing anticoagulant medications.
Discontinue use two weeksprior to surgery.
St. John’s Wort (amber, goatweed, Hypericum, klamatheweed)
Inhibits re-uptake of neurotransmitters (similar toProzac)
Alters metabolisms of otherdrugs such as cyclosporin (for transplant patients), warfarin, steroids, protease inhibitors (vs HIV). May interfere with many other drugs.
Discontinue at least 5 daysbefore surgery.
Inhibits re-uptake of neurotransmitters (similar toProzac)
Alters metabolisms of otherdrugs such as cyclosporin (for transplant patients), warfarin, steroids, protease inhibitors (vs HIV). May interfere with many other drugs.
Discontinue at least 5 daysbefore surgery.
Valerian
Sedates
Could increase effects ofsedatives. Long-term use could increase the amount of anesthesia needed. Withdrawal symptoms resemble Valium addiction.
If possible, taper dose weeksbefore surgery. If not, continue use until surgery. Treat withdrawal symptoms with benzodiazepines.
Sedates
Could increase effects ofsedatives. Long-term use could increase the amount of anesthesia needed. Withdrawal symptoms resemble Valium addiction.
If possible, taper dose weeksbefore surgery. If not, continue use until surgery. Treat withdrawal symptoms with benzodiazepines.
Vitamin E 200 units or more
Fat soluble vitamin used inprevention/treatment of cardiovascular disease, cancer age related degenerative diseases.
Anticlotting benefits can prolongbleeding time.
Discontinue use two weeksprior to surgery.
Fat soluble vitamin used inprevention/treatment of cardiovascular disease, cancer age related degenerative diseases.
Anticlotting benefits can prolongbleeding time.
Discontinue use two weeksprior to surgery.
Yohimbe (corynanthe yohimbe)
Natural Viagra that hasMOA effects. Purported to have psychological/physical effects.
Increases the potency ofanesthetics
iscontinue use two weeksprior to surgery.
Natural Viagra that hasMOA effects. Purported to have psychological/physical effects.
Increases the potency ofanesthetics
iscontinue use two weeksprior to surgery.