Preparing for surgery and recovery
What should I do with my medicines before surgery?
Agree on a separate stopping and restarting plan for each medicine.
At a glance
- Disclose medicines, injections and supplements.
- Confirm stopping and restarting for each medicine.
- Ask clinicians to resolve conflicting instructions.
Preparing for surgery does not mean stopping every medicine. Reducing surgical bleeding and keeping heart disease, blood pressure and diabetes stable must be considered together. Ask your surgical team and usual prescriber to work from the same medication list rather than following another patient’s instructions.
Keep the medication plan connected
- 01
Make a list
Medicines, injections, supplements and reasons
- 02
Confirm the plan
Last dose and operation-day instructions
- 03
Check again
Discharge medicines and restarting dates
A sequence showing a medication list, the preoperative plan and the discharge plan
About one month before surgery, we review your health and medicines
Testing usually takes place about one month before surgery to check whether you are fit for the operation. Bring a list of your regular medicines, injections, and supplements.
Any medicines that need to be adjusted or stopped are discussed individually, taking into account why you take them and the anesthesia plan. Confirm the last dose before surgery and when to restart with the surgical team.
Start with a complete list
List prescriptions, shop-bought pain relief, injections, herbal remedies and supplements. Include doses, frequency and the last dose taken. Bringing packets or photographs helps the team spot duplicate ingredients.
For blood-thinning medicines, record why you take them: a heart stent, atrial fibrillation or an earlier clot may change the risk of stopping. If instructions differ between hospitals, ask the teams to reconcile them instead of choosing a compromise yourself.
What should I do about my medicines before surgery?
Bring your medicine packets or prescription and a list of supplements before surgery. Ask the clinical team to write down the last dose before surgery and the date for restarting each medicine. The timings below illustrate differences to discuss with your clinicians; they are not a schedule for stopping medicines on your own.
Aspirin alone — Aspirin alone can sometimes be continued. Your clinicians decide whether to continue or stop it after checking bleeding risk and why you take it. If you take it because of a coronary stent, do not stop it on your own.
Clopidogrel — The guidance gives different examples for clopidogrel: five days before general anaesthesia and seven days before spinal or epidural anaesthesia. Confirm the plan for your operation and anaesthetic, including whether you have a coronary stent.
Warfarin — Warfarin is often adjusted from about five days before surgery. A blood test, the INR, must be checked before spinal or epidural anaesthesia. Whether an injection is needed while warfarin is withheld depends on an assessment of your blood-clot risk.
Apixaban, rivaroxaban and edoxaban — For medicines such as apixaban, rivaroxaban and edoxaban, the interval depends on the operation’s bleeding risk and the anaesthetic technique. The spinal or epidural example in this guidance is three days, but your clinicians adjust it for the dose and kidney function.
Dabigatran — Dabigatran may need a longer interruption, particularly if kidney function is reduced. Do not apply another anticoagulant’s schedule to this medicine.
Get written instructions for the operation day
Check which medicines to take, which to hold and what water is permitted. Ask about fasting separately from medication instructions. If you have already taken a morning dose, tell the anaesthesia team the name and time.
Persistent new chest pain, severe or sudden breathlessness, or fainting requires immediate emergency help; do not wait for the operation date. In Korea, call 119 and do not drive yourself. Promptly report marked dizziness, substantially changed glucose readings or other new health changes to the surgical team or usual prescriber.
Restarting medicines after surgery
The restart time depends on bleeding control, the operation’s bleeding risk, kidney function and whether an anaesthetic catheter is in place. Before discharge, confirm the date and time of your next dose in writing.
Common Questions
Must every blood thinner be stopped?
No. The reason you take it and the risks of surgery and anaesthesia guide the decision. Stopping without advice can increase clot risk.
What if I took a medicine before coming in?
Tell the team its name, dose and time immediately. The surgical and anaesthesia teams will decide what is needed.
Do supplements count?
Yes. They may affect bleeding or anaesthesia or interact with prescribed medicines.
Evidence and references
01When to seek medical care
Each warning sign is a separate reason to seek care. Follow the action below if any one applies.
Emergency department · call 119 in Korea
- Call 119 for sudden breathlessness or chest pain, severe faintness or loss of consciousness. Do not wait for calf swelling to appear.
- Go to an emergency department if you suddenly cannot bear any weight, or if an injured knee swells rapidly or looks deformed. A cold or numb foot after injury also needs immediate assessment.
- Seek emergency care for a hot, swollen and severely painful joint with high fever, shaking chills, confusion or inability to bear weight.
- With back or leg pain, go immediately to an emergency department for new difficulty passing urine, loss of bladder or bowel control, or numbness around the genitals or anus. Severe or rapidly worsening weakness or numbness in both legs also needs immediate assessment.
Same-day assessment
- Arrange assessment today for a newly hot, swollen joint, sudden severe pain, or a knee locked so that it cannot fully straighten. Joint infection can occur without fever.
- Have new swelling or pain in one calf assessed today for a possible blood clot. Call 119 immediately if breathlessness or chest pain develops.
- Severe knee pain or a new limp in a growing adolescent may come from a hip condition such as slipped capital femoral epiphysis. Stop walking and sport and arrange assessment today. Go directly to emergency care if they cannot bear weight.
- Stop running and seek assessment today for new recurring groin pain, pain with walking or at night, or a limp. A femoral neck stress fracture needs to be considered. Keep weight off the painful leg until assessed. Go to emergency care if you cannot bear weight.
Book an outpatient appointment
- If none of the warning signs above is present, book an appointment for pain lasting a few weeks, repeated swelling or reduced daily activity and exercise.