To our patients:

MEDICATIONS TO DISCONTINUE PRE AND/OR POSTOPERATIVELY

Patients having surgery must discontinue any medication that contains aspirin or other non-steroidal anti-inflammatory
agents and diet pills for at least (2) weeks before surgery. This includes, but is not limited to, Phen-Fen (Phentermone and
Fenfluramine), Redux, and pother prescriptions and non-prescription diet pills.
Aspirin has an affect on your blood's ability to clot and could increase your tendency to bleed at the time of surgery and
during the post-operative period. Reaction between diet pills and anesthetic drugs could result in disturbances in your
heart rhythms and could even cause cardiac arrest or death.
If you need minor pain medication, please take Tylenol. Tylenol is available at your pharmacy without prescription and has
an action very similar to that of aspirin. If you are allergic to Tylenol or unable to take it for other reason, please notify us
so we might arrange for a suitable substitute.

You must discontinue these medications for at least (2) weeks prior to surgery. Failure to do so may result in
cancellation of your procedure.

Section 1
The following drugs either contain aspirin and/or have undesirable side effects that may affect your surgery
(abnormal bleeding and bruising). These drugs should be avoided for at least two weeks prior to surgery. If you
need to take something for relief of minor pain, you may take Tylenol.

A.P.C.
Tom Landry Sports Medicine and Research Center

Section 2
The drugs listed below can have undesirable side effects that may affect your anesthesia or
surgery. Please let us know if you are currently taking any of these medications:

Achromycin

Section 3
The following foods contain salicylates, which affect blood clotting. The do not need to be omitted
completely from your diet, but should be kept to a minimum for two weeks prior to your surgery.

Almonds

Section 4
Nutritional supplements may be beneficial for a variety of ailments but their use around the time of
surgery may not be desirable. Therefore, it is advisable to stop taking these products to avoid problems
with surgery and/or anesthesia. If time permits, discontinue the use of these products two weeks prior to
your surgery and two weeks after your surgery.
Bilberry (vaccinium myrtillus) – contain anthocyanosides, flavonoid compounds that improve visual acuity and are
important in the treatment of eye disorders. Is an excellent antioxidant that strengthens capillaries and collagen. Has
anti-platelet activity and may inhibit clot formation.
Cayenne (capsicum annum) – used for GI tract disorders. Overdose may cause severe hypothermia.
Dong Quai (angelica sinesis) – the main application is in the relief of menstrual disorders and menstrual cramps.
Often used to relieve menopausal symptoms. Active constituent is coumarin derivatives, which may potentiate
existing anticoagulant medications.
Echinacea (echinacea augustfolia) – immune system stimulant with anti-inflammatory, antiviral and antibacterial
effects. Used as a prophylaxis for upper respiratory infections. Use of echinacea may impact the liver when general
anesthetic or certain other medications such as anabolic steroids or methotrexate are used.
Tom Landry Sports Medicine and Research Center
Feverfew (tanacetum parthenium) – used for migraine headache prevention and for arthritis, rheumatic disease,
and allergies. May increase bleeding, especially in patients taking certain anti-clotting medications.
Fish oil caps – supplies important omega-6 fatty DHA and EPA used to reduce cholesterol and triglyceride effects.
Has blood thinning properties.
Garlic (allium sativum) – garlic has vasodilatory, hypocholesterolemic effects and antiplatelet effects. May augment
effects of Coumadin, Warfarin, and NSAIDS causing abnormal bleeding time.
Ginger (zingiver officinale) – useful as antispasmodic, anti-inflammatory and anti-nauseant. Prophylactic for motion
sickness and used to stimulate appetite. Useful for post-op emesis. Use of ginger may alter bleeding time. Ginger
may interfere with cardiac and anticoagulant medications.
Ginkgo Biloba (ginkgo biloba) – one of the oldest living tree species which can live up to 1,000 years and grow to a
height of 120 feet. Used as an antioxidant and circulatory stimulant. Used for treatment of intermittent claudication,
tinnitus, vertigo, memory enhancement, and sexual dysfunction. Anticoagulant activity is 3x stronger than Vitamin E.
Ginseng (panax ginseng/panax quinquefolium) – at least three different varieties: Asian, American, and Siberian.
Improves physician and cognitive performance, mood or metabolism. An adaptogen and an antioxidant.
Anticoagulant that may interact with cardiac, hypo/hypertensive medications and hypoglycemic agents.
Hawthorne (crataegus laevigata) – the extract is used for its ability to potentiate the action of cardiac glycosides.
Used in the treatment of ischemic heart disease, hypertension, angina and chronic congestive heart disease.
Potentiates the actions of digitalis and other cardiac glycosides.
Kava Kava (piper methysticum) – sedative, analgesic, soporific, anti-convulsant, muscle relaxant, anxiolytic. Similar
to the effects of benzodiazepines in treatment of anxiety. May potentiate CNS effects of barbiturates, alcohol,
antidepressants, antipsychotics, and general anesthetics.
Licorice root (glycyrrhiza glabra) – used for gastric and duodenal ulcers, gastritis, and cough/bronchitis.
Glycyrrhzic acid in licorice may cause high blood pressure, hypokalemia, and edema.
Ma Huang (ephedra sinica) – used in weight loss and energy products; a natural amphetamine with powerful
stimulant effects. More than 800 adverse reactions reported with the FDA. Causes hypertension, tachycardia,
cardiomyopathy, and cardiac dysrhythmias.
Melatonin – a hormone secreted by the pineal gland. Regulates many other hormones that are involved in controlling
circadian rhythm. Used for jet lag, insomnia, and SAD (seasonal affective disorder). May potentiate CNS effects of
barbiturates and general anesthetics.
St. John’s Wort (hypericum perforatum) – herb used as mild anti-depressant, sedative, or anxiolytic. May have a
monoamine oxidase (MOA) inhibitory effect. Can interact with MAO inhibitors and other anti-depressants. Many other
drug interactions reported.
Valerian (valeriana officinalis) – used as a sedative, hypnotic, and anti-spasmodic in the GI tract. Relieves anxiety,
nervousness, and insomnia. May increase effects of sedative hypnotics.
Vitamin E – important fat-soluble vitamin that acts as an antioxidant and prevents oxidation of polyunsaturated fatty
acids. Used in the prevention and treatment of cardiovascular disease, cancer, age-related degenerative diseases.
Anti-clotting benefits can prolong bleeding time.
Yohimbe (corynanthe yohimbe) – “Natural Viagra” that has MAO effects. Yohimbe is the agent extracted from the
bark of the yohimbe tree. The tree grows in African nations of Cameroon, Gabon, and Zaire. Purported to have both
psychological and physical effects. Increases the potency of anesthetics.
If you have any questions regarding the above medications or any medication you are taking, please do not hesitate
to call our office.
Tom Landry Sports Medicine and Research Center

Source: http://www.drgibby.com/meds-to-avoid.pdf