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Medications to Avoid Before Outpatient Surgery

If you are considering having a procedure in the safe setting of an outpatient surgery center in the Triangle, it is recommended that you are prepared in the best way you can. Your doctors will make sure the outcome of the procedure is the most beneficial that it can be. But there are factors that you, as the patient, should take into consideration when getting ready for this important day.

One of these factors, among diet, physical therapy, stopping smoking, or keeping your doctor’s special instructions, is the use of certain medications, even up to two weeks before surgery. 

Here is the list of those you should avoid or stop taking:

Anticoagulants (blood thinners)

Anticoagulants (blood thinners) should usually be stopped several days prior to your surgery. Oral medications may need to be replaced with injected or intravenous (IV) medications. It is very important that both your surgeon and your physician (who prescribed the medication) discuss the specific timing for stopping these medicines. Please be aware that many drugs and herbal products may be blood-thinners even though they are not used for that purpose.

Prescription anticoagulants include:

  • warfarin 
  • enoxaparin 
  • clopidogrel 
  • ticlopidine 
  • aspirin (in many versions) – stop 2 weeks before
  • non-steroidal anti-inflammatory (NSAIDs) 
  • dipyridamole 

Non-prescription (over-the-counter herbal) anticoagulants include:

  • Aspirin (in many versions) – stop 2 weeks before
  • non-steroidal anti-inflammatory (NSAIDs) 
  • Vitamin E
  • garlic
  • ginger
  • Ginkgo Biloba

No regional anesthesia can be administered in the setting of anticoagulant therapy.

Monoamine Oxidase Inhibitors (MAOIs):

Drugs in this group include some anti-depressants and most anti-Parkinson drugs. MAOIs can interfere with many of the medications used in the course of anesthesia. If the medication needs to be stopped, it should be done one to two weeks prior to your surgery as it takes this long for the drug to be removed from your system. You should discuss this with your surgeon and primary physician as early as possible.

MAOIs include:

  • tranylcypromine
  • phenelzine 
  • isocarboxazid 
  • rasagiline 
  • selegiline 
  • linezolid 
  • St. John’s Wort

​Diabetic medication

Considering you will not be eating before surgery, most diabetic medication is usually modified by your physician. These include: 

  • Insulin
  • Metformin
  • empagliflozin 
  • pioglitazone 
  • insulin glargine 

Pain, anxiety, depression, or sleep medication

These can affect your pain management plan and side effects from opioid use. Visit for more information.

In this category of medication, you will find:

  • Hydrocodone 
  • tramadol 
  • oxycodone with acetaminophen 
  • pregabalin 
  • diazepam 
  • non-steroidal anti-inflammatory (NSAIDs) 

Nicotine, alcohol, marijuana or cannabidiol (CBD) products

These substances, used both for medicinal or recreational use, may affect your heart rate, blood pressure, and pain control during and after your procedure. Go to  to help you quit smoking before the surgery.

Remember, it is important to fully inform your surgical team about all of the medications you are taking before your surgery, including prescriptions, vitamins, minerals, herbs, drugs, or any other supplements.

Here you will find a list of medications for you to fill out and pass to your surgeon, prepared by the American College Of Surgeons.

In the end, outpatient surgical centers provide many benefits and advantages for surgical patients. If you have any other questions concerning surgeries performed in outpatient surgery centers, or would like to know how our outpatient surgery center can cater to your needs, please contact our Outpatient Surgery Center, NC. We will be more than happy to answer all of them, in the most professional and understanding way. 


The Raleigh Orthopaedic Surgery Center’s board certified  fellowship-trained surgeons bring together many years of experience to manage and treat joint complications resulting from degenerative joint diseases such as arthritis, musculoskeletal disease or joint trauma.

To schedule an appointment wit our Outpatient Surgery Center, NC, please call 919-719-3070.


The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers any questions or concerns you may have regarding your health.