Most people know it’s important not to eat or drink for several hours before an operation. But, what do you do about your medicines? The answer to this question depends on several things: the medicines you are taking, your health conditions, and the type of operation you are having.

Continue as normal

Most medicines should be taken as normal before an operation, so you don’t interrupt their beneficial effects. This will help ensure that your operation and recovery go as smoothly as possible.

Unless told otherwise by the surgeon, anaesthetist or pre-admission clinic, take your regular morning medicines with a few sips of water up to two hours before the operation. Medicines for high blood pressure, angina, asthma, stomach ulcers and epilepsy are examples of medicines that are usually continued as normal.

Exceptions

However, there are exceptions. Some medicines may increase your chances of having problems during or after the surgery, or they may hinder your recovery, because they

• increase the chances of bleeding
• increase the chances of other problems occurring
• change the effect of the anaesthetic
• change the effect of drugs given after the operation.

Some of these medicines should be stopped completely before your operation. Aspirin, warfarin, anti-platelet medicines such as Plavix or Iscover, anti-inflammatory arthritis medicines (NSAIDs) such as ibuprofen, and herbal medicines such as gingko and ginseng are examples of medicines that you will usually be told to stop.

Some other medicines should be continued as normal, but the anaesthetist needs to know about them, so they can adjust the amount or type of anaesthetic they give you. Medicines for anxiety, sleeping, depression and some pain medications are examples of medicines in this category.

Tell your surgeon and anaesthetist

It is vital that your surgeon and anaesthetist know about all the medicines you are taking, so they can ensure that your operation goes as safely and as successfully as possible.

When you agree to have your operation, give the surgeon a list of all your medicines, or tell them about all the medicines you are taking. This includes any prescription, over-the-counter, herbal and natural medicines, as well as any you might not think are important, such as aspirin, supplements and vitamins.

Ask the surgeon if you should stop taking any of your medicines before the surgery. If advised to stop, ask when you should stop it — it could be anything from 1–2 days to 2–3 weeks beforehand. Also, ask when you can re-start it after the operation.

If you are concerned about stopping a medicine you feel you rely on, ask your doctor if there is another medicine you could take during this time. For example, people who normally take NSAIDs for arthritis may be advised change to paracetamol (eg Panadol) to minimise their joint pain and stiffness.

You also need to have details of your medicines on hand at the pre-admission clinic and when you go into hospital or day surgery for the operation. Therefore, it will pay to make a list of all your medicines. The list should include any you have temporarily stopped.

Key points Tell your surgeon and anaesthetist about all the prescription, over-the-counter, herbal and natural medicines you are taking. Continue taking your prescribed or recommended medicines, unless advised to stop. If advised to stop a medicine, ask when you should stop and restart it. At the pre-admission clinic and when you are admitted, tell the hospital about all the medicines you take. Best of all take a list. If you have any questions about continuing or stopping medicines, contact your surgeon or anaesthetist.