Medications and Supplements to Stop Taking

Prescription Medications That Can Lead to Surgical Complications

Certain prescription heart medications, diabetes medications, blood-thinners, and other medications can increase the chance of surgical complications. You’ll need to work with Dr. Landford, along with your primary care physician or medical specialist, to make careful and specific changes to your dosage and medication schedule. Never stop taking any medication without consulting a medical professional first.

Prescription Blood Thinners

Prescription blood thinners can increase the likelihood of exacerbated bleeding during plastic surgery and exacerbated post-surgical bruising. These include aspirin, clopidogrel (Plavix), apixaban (Eliquis), warfarin (Coumadin), and rivaroxaban (Xarelto).

Prescription Anti-Diabetic Medications

Certain prescription antidiabetic medications, including insulin, metformin, and dulaglutide (Trulicity), may need to be adjusted or paused before a surgical procedure. This helps patients avoid becoming hyperglycemic or hypoglycemic during surgery. When the levels are incorrect, it can increase the possibility of infections and negatively affect the healing process.

Prescription Hormone Therapies

Hormonal medications like birth-control pills and hormone replacement therapy can increase the likelihood of developing blood clots (thromboembolic events) during and after surgery. To avoid pulmonary embolisms and deep vein thromboses, you may need to change or discontinue these types of medications temporarily. Depending on your medical history and surgical plan, adjustments to certain hormone therapies may be recommended to reduce the risk of blood clots.

Weight-Loss Medications

Certain weight-loss medications, including naltrexone-bupropion (Contrave), phentermine (Adipex-P, Fastin, Lomaira, Zantryl), and phendimetrazine (Melfiat), can have negative effects when taken before surgery. The stimulants in diet pills can lead to an increase in blood pressure and heart rate, which are not ideal when anesthetics are being administered.

Injectable GLP-1 medications, including semaglutide (Ozempic®, Wegovy®) and tirzepatide (Mounjaro®, Zepbound®), may also require temporary discontinuation before surgery. These medications can slow gastric emptying, which may increase certain anesthesia-related risks. During your preoperative appointment, Dr. Landford’s clinical team will provide specific guidance on when to pause and resume these medications.

Diuretics

Diuretics (water pills) like hydrochlorothiazide (HCTZ), spironolactone (Aldactone), and furosemide (Lasix) result in imbalances in the body’s electrolyte levels. This can result in anesthesia-related issues and dehydration during plastic surgery.

Antidepressants

SSRIs (selective serotonin reuptake inhibitors) and MAOIs (monoamine oxidase inhibitors) are types of antidepressants that can cause issues during plastic surgery. SSRIs can exacerbate surgical bleeding, and both types of antidepressant medications can have negative interactions with anesthetics and other medications administered during surgery. These interactions can result in changes in heart rate and blood pressure.

Steroid Therapies

Prescription steroid therapies, including corticosteroids like dexamethasone and prednisone, must be discussed before scheduling plastic surgery. These therapies can interfere with the immune system, cause problems with wound healing, and even result in adrenal insufficiency, which can be extremely dangerous.

Anxiety and Pain Medications

You may have to adjust the dosages of certain anxiety and pain medications before plastic surgery. Medications like hydrocodone (Vicodin), pregabalin (Lyrica), diazepam (Valium), tramadol (Ultram), and oxycodone with acetaminophen (Percocet) can cause issues relating to post-surgical pain relief.

Which Over-the-Counter Medications Can Cause Surgical Complications?

Over-the-counter (OTC) medications are especially important to pay attention to before surgery, since people are often accustomed to taking them without thinking. The following types of OTC medications can cause complications during and after plastic surgery:

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs

Avoid taking all NSAIDs two weeks before surgery, including pain-relief medications like acetylsalicylic acid (aspirin), naproxen (Aleve), ibuprofen (Advil), and diclofenac (Voltaren). Instead, stick with acetaminophen (Tylenol) when recommended.

NSAIDs can thin the blood before surgery, reducing its ability to clot. As a result, bleeding increases, which can be quite dangerous for patients. It can also greatly exacerbate post-surgical bruising.

Cough Suppressants

OTC cough suppressants containing dextromethorphan (Delsym, Vicks DayQuil Cough) can have negative interactions with medications utilized in surgery, including anesthetics. These negative interactions can include increased drowsiness and nervous system issues.

Antihistamines

Diphenhydramine (Benadryl) and other OTC antihistamines can interact negatively with anesthetics and cause issues during and after surgery. They can cause blurred vision, dry mouth, confusion, excessive drowsiness, difficulty breathing, and more.

Decongestants

Pseudoephedrine (Sudafed), phenylephrine, and other OTC decongestants typically cause elevated blood pressure, higher blood sugar levels, and a faster heart rate because they are sympathomimetics. Combining these with anesthesia makes it harder to monitor heart rate and blood pressure during surgery. Certain decongestants constrict blood vessels, making anesthesia less effective and increasing the risk of tissue damage. They can also suppress the immune system, increasing the risk of infections after surgery.

Your Consultation

As part of your preoperative planning process, Dr. Landford and her clinical team will review your current prescriptions, over-the-counter medications, and dietary supplements. This review helps identify any medications that may need to be adjusted before surgery to support a safe procedure and smooth recovery.

You will be provided with a personalized timeline outlining when medications should be paused, adjusted, or resumed. When necessary, Dr. Landford’s team will also coordinate with your primary care physician or medical specialists to ensure your care remains safe and uninterrupted.

During your consultation, make sure to ask the following questions:

• When should I specifically stop and continue taking each of my medications and supplements?
• If there is a health emergency and I need to take a certain medication, who should I contact?
• Which of my medications and supplements are optional, and which are vital?
• Which alternatives are available for each of my medications and supplements?

Your Pre-Surgery Timeline

Once you have received your pre-surgery guidelines, follow them as closely as possible. If there are any mistakes, you’ll need to contact your plastic surgeon immediately to discuss your options.

Typically, any changes to medications and supplements will begin within the two-week window before your surgical session. Starting early is the best way to ensure your body has time to fully process the medications and supplements.

Certain medications must be avoided for the entire two weeks before the procedure, while others must only be avoided in the days leading up to it.

On the Day of Surgery

On the day of your plastic surgery procedure at Landford Plastic Surgery in Washington, D.C., take only essential medications. Only very small sips of water should be taken for any pills you need to swallow. You’ll also need to bring your updated list of medications and supplements with you to the procedure.

Arrange Your Consultation

Schedule your personalized consultation at Landford Plastic Surgery to find out which medications are safe to take before your procedure. Patient safety is our top priority. To arrange your consultation at one of our Washington, D.C. or Chevy Chase locations, call us at (301) 235-1900.