Medications
Medications to Stop Before Surgery
Some medications raise bleeding risk or interfere with anesthesia and need to be paused — a few days in advance. Here's a clear list, but your surgeon must confirm your personal plan.
Try the take-or-hold checker
Never stop a blood thinner on your own
Common stop-before times
These are typical windows. Your exact timing depends on your surgery and your health, so treat this as orientation — not your instruction.
| Medication | Often stopped |
|---|---|
| Aspirin — low dose (75 mg) | Usually continued — don't stop without advice |
| Aspirin — higher dose | May stop ~7 days before — confirm with team |
| NSAIDs — ibuprofen (Advil, Motrin), naproxen (Aleve) | ~7 days before |
| Clopidogrel (Plavix) | ~5–7 days before |
| Apixaban (Eliquis), rivaroxaban (Xarelto) | ~72 hours (3 days) before — longer if kidneys reduced |
| Dabigatran (Pradaxa) | ~3–5 days before (by kidney function) |
| Warfarin (Coumadin) | ~5 days before (with INR check) |
| Fish oil, vitamin E, ginkgo, high-dose turmeric | ~7 days before |
If you may have a spinal or epidural
Drug-by-drug guides
Tap any medicine for a clear page — what to do, why it matters, and what to ask your team.
Vitamins & supplements
'Natural' doesn't mean safe around surgery — several thin the blood. See the full supplements guide, or tap one:
Medications usually continued
Many drugs should not be stopped. These are often taken as normal with a small sip of water on the morning of surgery:
- Most blood pressure medications (with some exceptions your team will note)
- Acetaminophen (Tylenol) — generally safe and doesn't thin the blood
- Thyroid, seizure, and most heart medications
- Inhalers for asthma or COPD
Do this at your pre-op appointment
Special case: Ozempic and weight-loss injections
GLP-1 medications (Ozempic, Wegovy, Mounjaro) aren't about bleeding — they slow stomach emptying, which is an anesthesia concern. They have their own rules: see the GLP-1 before-surgery guide.
Why bleeding risk matters
Surgery always involves some blood loss. Blood thinners and certain supplements reduce your blood's ability to clot, which can make bleeding harder to control during and after the procedure. Pausing them at the right time lets your clotting return to normal while keeping you protected for as long as possible.
Frequently asked questions
How many days before surgery do I stop blood thinners?
It varies by drug. Using anesthesia (ASRA) guidance: NSAIDs like ibuprofen about 7 days before; clopidogrel (Plavix) about 5–7 days; apixaban (Eliquis) and rivaroxaban (Xarelto) about 72 hours (3 days), and dabigatran (Pradaxa) about 3–5 days, depending on kidney function; warfarin (Coumadin) about 5 days with an INR check. Low-dose aspirin (75 mg) is frequently continued. Never stop a prescribed blood thinner without your doctor's plan, as some people need bridging medication.
Do I need to stop aspirin before surgery?
It depends on the dose and why you take it. Low-dose aspirin (around 75 mg) for heart or stroke protection is often CONTINUED through surgery. Higher doses may be stopped about 7 days before. Do not stop aspirin on your own — confirm with your surgical team, especially if you have a stent or heart disease.
Should I stop ibuprofen before surgery?
Usually yes. Over-the-counter NSAIDs like ibuprofen (Advil, Motrin) and naproxen (Aleve) thin the blood and are commonly stopped about a week before surgery. Acetaminophen (Tylenol) does not thin the blood and is generally fine. Confirm with your surgeon.
Can I take my regular medications the morning of surgery?
Many routine medications (such as most blood pressure pills) are taken as usual with a small sip of water. Others are held. Your pre-op team will give you a specific list — bring all your medications and doses to that appointment.
What about vitamins and supplements?
Several supplements increase bleeding risk — including fish oil, vitamin E, ginkgo, ginger, garlic and high-dose turmeric — and are often stopped about a week before. Tell your team everything you take, including herbal products.