Medications and Supplements to Avoid Before Surgery
Certain prescription medications, over-the-counter drugs, vitamins and mineral supplements, and herbal products should not be taken if possible in the two weeks before liposuction surgery.They can interfere with anesthesia and other medications used during liposuction, or they can affect blood clotting. Make sure that your surgeon and anesthesiologist have a complete list of all the medications you take, including any herbal products. You should also honestly discuss with the surgeon any recreational drugs that you use.
Aspirin and ibuprofen, and any products containing those ingredients, should be avoided for a week or two before liposuction because they can interfere with blood clotting and possibly cause excessive bleeding. If you need to take a pain reliever, take acetaminophen (Tylenol).
Also, if you smoke, stop smoking at least 2 weeks before your surgery date and don't start again afterwards for as long as possible. Smoking significantly reduces your body's circulation and healing. This might be a good time for you to stop smoking completely.
Aches-N-Pains, Actifed, Acuprin, Addaprin, Adprin - B Tablets, Adult Analgesic Pain Relievers, Advil, AK Spore - HC, Alka Seltzer, All Arthritis Medicines, Allergy Relief Medicines (A.R.M.), Alpha Omega (fish oil), Aluprin, Aleve, Amigesic Capsules, Amitriptyline, Anacin, Anacin Arthritis/P, Ansaid Tablets (generic brand of Ansaid is Flurbiprofen), Anodynos Tablets, Analval, Anaprox, Anaprox-DS, Anaproxen, Anaproxen Anodynos, Ansaid, APAC Improved, APC, Argesic Tablets, Arthra-G, Arthralgen Tablets, Arthritis Pain Formula, Arthritis Strength Bufferin, Arthropan, Arthropan Liquid, As-caff, Ascodeen, Ascriptin, Ascriptin AID tablets, Ascriptin with Codeine Tablets, ALL ASCRIPTIN PRODUCTS, Aspir-lox, Asperi-mox, Aspirbuf, Aspercin, Aspergum, Aspirin (of any kind), Aspirin Suppositories, Aspirin with Codeine, ASpirTab, Asprimox Tablets, Asproject, A.S.A. Tablets, A.S.A. Enseals, Axotal, Azdone Tablets
B-A-C Tablets, Bayer Aspirin, Bayer Children's Aspirin Tablets, Bayer Children's Cold Tablets, Bayer Timed-Release Aspirin Tablets, Bayer Select Pain Formula, BC Powder/Tablets, Bilberry Tablets, Brufen, Buf Tab, Buff-A-Comp, Buff-A Comp No.3 Tablets with codeine, Buffaprin, Buffasal, Bufferin, Bufferin 37%, Bufferin Arth, Bufferin X/S Butalbit, Buffets II, Buffex, Buffinol, Buropion, Buropion HCL, Butazolidin
C-Advil Cama, Cama Arthritis Pain Reliever, Cama Inlay Tabs, CataFlam Tablets, Carisoprodol Compoud Tablets, Cayenne, Cephalgesic, Cheracol Tablets, Children's Advil Suspension, Children's Aspirin, Children's Motrin Suspension, Chro,mium, Chromium Picolinate, Claritin, Clinoril, Concerta (for ADD/ADHD), Congespirin, Contac, Cope, Coricidin Tablets, Coricidin "D" Decongestant Tablets, Coricidin, Coricidin Demilets Tablets for Children, Coricidin Mediets Tablets for Children, Coumadin
Damason-P, Darvon, Darvon with ASA, Darvon Compound, Darvon Compound-65, Darvon w/Apspirin, Darvon-N with Apsirin, Dasin, Dipryridamole, Disalcid, Diurex, Doan's, Dolcn, Dolobid, Dolphirn #3 Tablets, Drinopehn, Dristan, Dristan Sinus, Duoprin-S Syrup, Duradyne Tablets
Vitamin E, E-aspirin, Easprin EC, Echinacea, Ecolrin, Ecotrin Tablets, EFFEXOR® XR, Elavil, Emagrin, Empirin, Empirin with Codeine, Emprazil, Endodan Tablets, Epromate Tablets, Equagesic, Equazine-M, Excedrin, EFFEXOR® XR (venlafaxine HCl) Extended-Release, ExPrazi
Feldene, Fenoprofen Tablets, Feverfew, Fiogesic Tablets, Fioricett, Fiorinal, Fiorinal with Codeine, Florgen PF, Fluoxetin, Flurbiprofen Tablets, 4 Way Cold Tablets
garlic (allium sativum) tabs & do not eat garlic excessively (some say not at all - but if you accidentally get some or have a little garlic toast, I am sure it's okay, it's more for garlic tablets), Genaced, Genacote, Gelpirin Tablets, Genprin, Gensan, Ghemnisym, Gingko, Ginbko Biloba, Gennin, Ginger, Gingko, Ginkobiloba, GNP aspirin, Goody's Headache Powder, Goody-s Extra Strength
Halfprin Tablets, Haltran, Heparin, Hydroxycut
IBU, IBU-Tab, Ibuprofen, Ibuprin, Ibuprohm, Indocin, Indochron E-R Capsules , Indomethacin Caspules, Indomethacin Suspension, Infantol Pill, Isollyl Improved Tablets & Capsules
J none available
Lanorinal, Licorice Root, Lodine, Lortab ASA
MAO inhibitors, Magan, Magnaprin, Magnasprin, Magsal, Marnal, Marthritic Tablets, Maximum Bayer Aspirin, Measurin, Meclomen, MecloFenamate Capsules, Medigistic-Plus, Medipren, Meditren, Melatonin, Menadol, Meprogesic Q, Micraninin, Midol/Midol 200, Midol Original, Midol PMS, Mobidin, Moblgesic, Momentum Back Ache Formula, Monogesic, Motrin, Motrin IB, Multi-Vitamin
Nalfon, Nardil, Nardilzine, Naprosyn, Neomycin, Neogesic, Norgesic, Norgesic Forte, Norwich Extra Strength Aspirin, Nov-naproxen, Nuprin, NyQuil/NyQuil P.M.
Orphenagesic, Orphenagesic Forte, Orudis, Oruvail Capsules, Oxycodine, Oxycodone
P-A-C, Pabalate-SF, Pabrin, Pacaps, Pain Reliever Tablets, Pamprin-IB, Panalgesic, Panodynes, Papaya, PediaProfen, Pedrazil, Percodan, Percodan Demi Tabs, Persantin, Persisrin, Persistin, PetoBismol, Phenaphen, Phenetron Compound, Piroxicam Capsules, Polymyxin, Ponstel Capsules, Presalin, Propoxyphene Compound, Propoxyphene Napsylate with Aspirin, Prozac
Quagesic, Quiet World Analgesic (sleeping aid), Quinine
Relafen Tablets, Rexolate, Rhinex, Robaxin, Robasisal, Roxiprin Tablets, Rufin, Robaxisal
S-A-C, Salabuff, Salatin. Saleto, Saleto 200, Saleto-400,600,800 Tablets, Salflex, Salicylamide, Salocol, Salsalate, Salsitab, Serzone, Sign Off Sinus Tablets, Sine Aid, Sine Off, SK-65 Compound Capsules, Soma Compound, Soma Compound with Codeine, St. Joh'ns Wort, St. Josephs Aspirin, St. Joseph Cold Tablets (for children), Stanback Analgesic, Stanback Powder, Sudafed, Sulindac Tablets, Supac, Synalogos Capsules, Synalgos-DC Capsules
Talwin Compound, Tenol-Plus, Tolectin 200,600 Tablets, Tolectin DS Capsules, Tolmetin Tablets/Capsules, Toradol Injection/Tablets, Tr-Pain Tablets, Trilisate Tablets and Liquid, Trendar, Trental, Triaminicin Tablets, Tricosal tablets, Tri-Pain, Trigesic, Trilisate, Tusal
Ultrapin, Unipro, Ursinos Inlay Tablets
Valesin, Valtrex, Vanquish, Verin, Viro-Med Tablets, Vivarin, Voltaren
Warafin (Coumadin), Wellbutrin, Wesprin Buffered
X none available
Zactrin, (Zoloft has anti-coagulant properties so just advise your anesthesiologist if you take it) Zorprin, Zyban
Plus any other aspirin containing medication, be it natural, prescription or over the counter. Alert your doctor of any medications or supplements you may be taking. Even natural supplements have their risks. Read below...
Other Supplements, Vitamins and Herbal Remedies not to ingest and why...
I know many of you may take herbal supplements and some are good but MANY are contraindicated with anesthesia or surgery in general. Some reasons why you may not wish to disclose your herbal consumption information to your surgeon or anesthesiologist may be because you believe that since these supplements are over the counter (OTC) they must be safe to use. This isn't true - may of these are contraindicated and can severally hurt you when used in conjunction with anesthesia, other medications or while undergoing surgery. You may also think that because these products are safe - Most medications and dangerous drugs and poisons ARE FROM PLANTS. So please remember this. You may also think that telling your surgeon or anesthesiologist would be embarrassing - especially if you shouldn't be taking them, if you are taking them for weight loss, increase your sexual stamina, for acne or for depression. This is your life - don't mess around!
Vitamin E is number one no-no. It has anti-platelet properties and inhibits vital clot formation. Please cease consuming Vitamin E at least 2-3 weeks prior to any surgery and for 2-3 weeks afterwards unless specifically instructed by your surgeon.
Garlic (allium sativum), Ginger, Alfalfa, Cayenne, Papaya, Feverfew, Chamomile, Dong Quai root, Willow bark, Goldenseal, Guarana, Horse Chestnut and Bilberry Tablets/Supplements, have anti-platelet properties and may inhibit vital clot formation. These medications are normally taken to remedy edema (fluid retention).
Gingko, Gingko biloba, & Selenium are powerful anti-coagulants. It is considered to be 3 times stronger than Vitamin E, which should also be avoided.
Ginseng may cause rapid heartbeat/and or high blood pressure in some individuals as well as coagulation disruption.
St. John's Wort, Yohimbe, ("The natural Viagra®") and Licorice root have a mild monoamine oxidase (MAO) inhibitory effect and may intensify the effects of anesthesia. (*note some well known and popular anti-depressants are MAO inhibitors, disclose any and all medications you are taking - your life may depend on it!)
Melatonin decreases the amount of anesthesia needed for surgery.
Kava Kava, Hawthorn, Lemon verbena, Muwort, Lavender and Valerian/Valerian Root: (taken to promote relaxation and sleep) have tranquilizing properties and should not be combined with other sedative agents. WARNING! Tell your anesthesiologist/surgeon if you take either one of these!!
Echinacea may have a severe impact on the liver when general anesthesia is used. Please advise your surgeon of all medications and supplements and alert him to the possible effects of herbal supplements and remedies, he may not be aware of the contraindications. it also has some coagulation disruption properties.
Ma Huang (aka Ephedra), : "(used by many for weight loss and is a major component of most weight loss supplements) has been associated with more than 800 adverse health effects including DEATH. It is an amphetamine-like compound with the potential for stimulating the central nervous system and heart.
WARNING! we strongly discourage the use of this supplement in any form." In large doses ephedrine causes nervousness, headaches, insomnia, dizziness, palpitations, skin flushing, tingling and vomiting (Lawrence Review, 1989). The Handbook of Nonprescription Drugs notes that "The principal adverse effects of ephedrine are CNS stimulation, nausea, tremors, tachycardia [rapid heartbeat], and urinary retention." (APhA 1986).
Gotu Kola has a stimulant effect as well.
Ackee fruit as well as, Alfalfa, Aloe, Argimony, Barley, Bitter melon, Burdock root, Carrot oil, Chromium, Coriander, Dandelion root, Devil's club, Eucalyptus, Fenugreek seeds, Fo-ti, large amounts of Garlic, Ginseng, Grape seed, Guayusa, Gmena, Juniper, Nem seed oil, large amounts of Onions, Periwinkle, Yellow root alter the blood glucose level.
Special Medication Alerts!
If you are on Anti-depressants, please advise your doctor. Some monoamine oxidase (MAO) inhibitors (also known as MAOI) intensify the effects of the anesthesia - especially General. This could be quite dangerous in the operating room if your doctor is unaware of your medication usage. If you advise your doctor he or she can make adjustments for your anesthesia or at least will watch for the slightest decrease in heart or breathing rate.
These medications may include: Isocarboxazid, Marplan, phenelzine (Nardil, Nardelzine) tranylcypromine (Parnate, Sicoton), Deprenyl, selegiline hydrochloride, 5 HTP, Amitriptyline, Prozac, Wellbutrin, Buropion, Buropion HCL, Fluoxetin, EFFEXOR® XR, etc.. They are used for the treatment of depression, obsessive-compulsive disorder, eating disorders, essential hypertension (pargyline), chronic pain syndromes, and migraine headaches. They work by inhibiting nerve transmissions in brain that may cause depression. Tranylcypromine and phenelzine account for over 90% of all MAO inhibitors currently prescribed.
It is reported that drug interactions can occur even weeks after discontinued use of an MAOI. Therefore, in patients undergoing General anesthesia, cessation of usage is normally instructed several weeks prior to surgery to avoid possible cardiovascular effects.
Diet Pills, Fat Loss Supplements & Stackers: Please, Please, Please! stop taking these pills at least 2 weeks before surgery. Many of these pills contain anticoagulants and can seriously impede your bodies ability to clot sufficiently resulting in hemorrhaging.
"Anesthetic Requirements: Anesthetic requirements are increased, reflecting accumulation of norepinephrine in the CNS." Ref: Stoelting, R.K, Pharmacology & Physiology in Anesthetic Practice, pp. 378-381.
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George John Bitar, MD
Robert F. Centeno, MD, MBA, FACS
Bitar Cosmetic Surgery Institute
3023 Hamaker Court
Fairfax, VA 22031
George John Bitar, MD
Robert F. Centeno, MD, MBA, FACS
Bitar Cosmetic Surgery Institute
8650 Sudley Road
Manassas, VA 20110
Michael J. Olding, MD, FACS
George Washington University Hospital
2150 Pennsylvania Avenue
Washington DC, DC 20037