Medications
Ibuprofen & NSAIDs Before Surgery
Ibuprofen and other anti-inflammatory painkillers (NSAIDs) thin the blood a little, so they're usually stopped about a week before surgery. The good news: paracetamol is a safe alternative for pain in the meantime.
Quick answer
Why it matters
NSAIDs work partly by making blood platelets less sticky. That's harmless day to day, but during surgery it can mean more bleeding and bruising, so teams ask you to stop them in advance to let your clotting return to normal.
NSAIDs can also affect the kidneys, which matters around an operation where blood pressure and fluids shift — another reason they're commonly paused.
Unlike aspirin (which affects platelets for their whole lifespan), the effect of ibuprofen wears off within a day or so — but a 5–7 day stop is the usual cautious window, especially if you might have a spinal or epidural.
Do not stop without instruction
What to ask your doctor
- How many days before surgery should I stop my ibuprofen or naproxen?
- Can I use paracetamol (acetaminophen) for pain until then, and how much?
- Is my aspirin different — do I keep taking that?
- When can I restart my anti-inflammatory afterward?
Red flags — call your team
Red flags — call your team
- Black, tarry stools or vomiting blood — possible stomach bleeding from NSAIDs (seek urgent care)
- You took ibuprofen or naproxen within the stop window your team gave you — tell them, don't just stay quiet
- Unusual bruising or bleeding that won't stop
References
- Hold timing reflects anesthesia (ASRA) and standard perioperative guidance; your surgical team's instruction takes precedence.
- Paracetamol/acetaminophen does not affect platelets and is generally continued for pain unless your team advises otherwise.
Frequently asked questions
Can I take paracetamol (Tylenol) instead of ibuprofen before surgery?
Yes — paracetamol (acetaminophen) doesn't thin the blood, so it's generally the recommended painkiller in the days before surgery once you've stopped NSAIDs. Stick to the dose on the packet and tell your team what you're taking.
Is naproxen the same as ibuprofen for stopping before surgery?
They're both NSAIDs and both thin the blood, so both are usually stopped before surgery. Naproxen lasts longer in the body than ibuprofen, so your team may want it stopped a little earlier — follow the specific timing they give you.
I take low-dose aspirin — do I stop that too?
Not necessarily. Low-dose aspirin (around 75–81 mg) for heart or stroke protection is often continued through surgery, unlike over-the-counter ibuprofen. Because stopping it can carry its own risk, never stop aspirin without your team's say-so.
When can I restart ibuprofen after surgery?
It depends on your operation — some surgeons are happy for you to resume once bleeding risk has passed, while others limit NSAIDs for a while (for example after some bone or stomach surgery). Ask your surgeon for the specific go-ahead.