Medications to stop prior to surgery for surgical patients
***PLEASE DO NOT HESTITATE TO CALL (515) 974-5465 OR EMAIL RESULTS@LAKEVIEWSURGERYCENTER.COM FOR QUESTIONS REGARDING MEDICATIONS***
This list may not include all medications and indications for use. You may also reach out to your primary care provider for clarification.
When holding medications, please include the day of your procedure as a hold date. (For example, if you are supposed to stop your medication 3 days before your procedure, and surgery is on a Monday, your last dose would be the Friday before surgery.)
| Anticoagulants/Antiplatelets- usually taken to keep blood from clotting: Apixaban, Aggrenox, Clopidogrel, Coumadin, Dabigatran, Dipyridamole, Eliquis, Jantoven, Plavix, Pradaxa, Ticlid, Ticlodipine, Warfarin, Xarelto, etc. | Stop as instructed by prescribing physician, either cardiologist or primary care. If not told to stop, call surgeon’s office for directions. Alphabetical order with stop dates- *these are general guidelines. If your doctor told you specific dates, you should follow their instructions.* Aggrastat- 4-8 hrs before surgery Aggrenox- 7 days before surgery Apixaban-3 days before surgery Arixtra- 2-3 days before surgery Aspirin Dipyridamole- 7 days before surgery Brilinta- 7 days before surgery Cilostazol- 2 days before surgery Clopidogrel- 7 days before surgery Coumadin- 5 days before surgery Dabigatran- 5 days before surgery Dalteparin- 12-24 hrs before surgery Dipyridamole- 1 day before surgery Edoxaban- 3 days before surgery Effient- 5 days before surgery Eliquis- 3 days before surgery Elmiron- 5 days before surgery Enoxaparin- 12-24 hrs before surgery- check with surgeon’s office if unsure Eptifibatide- 4-8 hrs before surgery Fondaparinux- 2-3 days before surgery Fragmin- 12-24 hrs before surgery Integrilin- 4-8 hrs before surgery Jantoven- 5 days before surgery Lovenox- 12-24 hrs before surgery- check with surgeon’s office if unsure Pentosan- 5 days before surgery Pentoxyfylline- 5 days before surgery Persantine- 1 day before surgery Plavix- 7 days before surgery Pletal- 2 days before surgery Pradaxa- 5 days before surgery Prasugrel- 5 days before surgery Rivaroxaban- 3 days before surgery Savaysa- 3 days before surgery Ticagrelor- 7 days before surgery Ticlid- 10 days before surgery Ticlodipine- 10 days before surgery Tirofiban- 4-8 hrs before surgery Trental- 5 days before surgery Warfarin- 5 days before surgery Xarelto- 3 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, etc. | 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, Nolvadex, Raloxifene, Tamoxifen | Stop 14 days before surgery for Nolvadex or Tamoxifen; Stop 3 days prior to surgery for Evista or Raloxifene- if not instructed by surgeon, ask surgeon’s office |
| Diet medications containing Phentermine: Adipex-P, Belviq, Bontril, Fastin, Lomaira, Phentermine, Phentermine/Topiramate, Qsymia, contrave, Suprenza, etc. | Stop 7 days before surgery |
| Glucagon-like Peptide 1 Receptor Agonists (GLP-1s) (WHEN TAKEN ONCE WEEKLY)- usually taken for Diabetes/weight loss: Adlyxin, Albiglutide, Bydureon/BCise, Byetta, Dulaglutide, Exenatide ER weekly dosing, Liraglutide weekly dosing, Lixisenatide, Mounjaro, Ozempic, Zepbound, Pramlintide, Rybelsus, Semaglutide ER weekly dosing, Symlin, Tanzeum, Tirzepatide, Trulicity, Wegovy, etc. | Stop 7 days before surgery |
| Antineoplastics- usually used for Cancer: 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, Ertugliflozin , Farxiga, Invokana, Jardiance, Steglatro, etc. | Stop 3 days before surgery for all except Ertugliflozin or Steglatro which should be stopped 4 days before surgery |
| Phosphodiesterase Inhibitors- usually taken for Erectile Dysfunction: 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, ask surgeon’s office |
| Diet medication not containing Phentermine: Contrave, Diethylpropion, Naltrexone/Bupropion, Tenuate, etc. – | Stop 3 days before surgery except for Diethylpropion or Tenuate which should be stopped 2 days before surgery |
| 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 |
| Glucagon-like Peptide Agonists (WHEN TAKEN DAILY OR TWICE DAILY)- usually taken for Diabetes/weight loss: Byetta, Exenatide IR twice daily dosing, Liraglutide daily dosing, Rybelsus, Saxenda, Semaglutide IR daily dosing, Victoza, 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, chewable, 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 taken for pain/swelling and vitamins/herbs/supplements: 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 |
