Preoperative Medications: What To Stop And When

Introduction
Most medications are safe to take prior to and up to the day of surgery. However, there are a selective few
medications that due to medical, bleeding, or infection concerns should be stopped prior to surgery. Below is a list
of some common Aspirin containing and Nonsteroidal Anti-Inflammatory Medications (NSAIDS) that should be
stopped 2 weeks prior to surgery. Additionally, Vitamin E should also be stopped 2 weeks prior to surgery.

Auto-Immune Disorders
Patients with Autoimmune diseases such as Rheumatoid Arthritis, Psoriatic Arthritis, Sjogren’s, Lupus, and others
may be taking certain powerful disease modifying medications that can lower your immune system. This can make
wound healing more difficult and even raise the risk of infection. These medications are known as Disease Modifying
Anti-rheumatic Drugs (DMARDS) and Biologic Agents. Below is the list of the most common of these medications and
the recommended stop times. This table was generated from a combined meeting of the American College of
Rheumatology (ACR) and the American Association of Hip and Knee Surgeons (AAHKS). Although this list is very
inclusive, if you do have an autoimmune disease and you are taking a medication not listed below, please ask your
surgeon and/or prescribing physician about recommendations for continuing or stopping the medicine prior to surgery.