Certain medications are known to increase bleeding. It is usually advisable to stop these before surgery to reduce the risk of complications.

These include:

• aspirin
• anti-inflammatory medications (over 30 different drugs such as ibuprofen and naproxen that may be over the counter or prescription)
• anti platelet agents ( such as persantine, plavix, aggrenox)
• anticoagulants (such as Coumadin, lovenox, pradaxa, xarelto)

If you tell us everything tat you are taking, we will inform you how long before surgery they must be discontinued. In patients who require long-term anticoagulation we usually stop these for a short time prior to surgery and then gradually resume them.

Over the counter supplements may contain chemicals that interfere with anticoagulant medication. They are not well studied; dosing is inexact and drug interactions are poorly understood. Therefore it is best to stop taking these one week prior to surgery and resume them only after we discontinue your routine postoperative anticoagulation.

You may continue Tylenol, celebrex and narcotic pain medication until the day of surgery.