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Nonsteroidal Anti-inflammatory Drugs to Stop Before Spinal Surgery



Below is a list of medications that are either nonsteroidal anti-inflammatory drugs or contain nonsteroidal anti-inflammatory drugs as a major ingredient. The drugs listed are prescribed to reduce inflammation or pain. They may have been prescribed to you by one or more of your physicians to treat the underlying condition for which you are having surgery, or perhaps they may have been prescribed to treat another condition unrelated to your surgical diagnosis. Also included in this list are several common "over-the-counter" pain medications that have a nonsteroidal anti-inflammatory drug as the major active ingredient (for example Motrin, Advil, Aleve and Nuprin).

Unfortunately, all of these medications can interfere with the success of your spinal surgery, since nearly all of these medications act as a "blood thinner" which can result in excessive bleeding at the time of your surgery. Therefore these medications must be stopped at least one week before your surgery in order to completely clear these medications from your system. If you are taking aspirin or a drug that contains aspirin (such as Anacin, Excedrin, Empirin, Empirin with codeine and Darvon compound-65), you must stop taking your medication a minimum of two weeks prior to your surgery. If you have had only a discectomy, foraminotomy or laminectomy, you may resume taking these medications after you are discharged.

If you have had a spinal fusion operation, these medications may not be restarted until some time after surgery since “inflammation” is a required part of the healing process for spinal fusion surgery. You must not resume taking these medications until Dr. Coe or his physician assistant Renee Wall has told you that it is safe to do so (usually 3-6 months postoperatively). Exception: If you’re taking 81 mg (low-dose) aspirin for the prevention of heart disease, please stop taking this medication 1-2 days prior to your surgery. You then can resume taking your low-dose aspirin as soon as you are discharged.

Pain medications that contained acetaminophen (the active ingredient in Tylenol) are generally safe to take. Examples of these include Ultracet and Darvocet. Also, generally it is not necessary to stop taking narcotic pain medications before spinal surgery (for example Vicodin, Darvocet, etc.) or other non-narcotic pain medications (for example Ultram) since these medications do not interfere with blood clotting or the healing of the spinal fusion process. For other reasons, however, it is important to reduce pain medicine intake prior to major surgery if it all possible. The most important reason for this is that taking large doses of narcotics preoperatively complicates the administration of anesthesia and the control of postoperative pain.

Drugs to Stop Taking Before Spinal Fusion Surgery

Advil
Aleve
Alka-Seltzer Plus Flu Medicine
Anacin
Anaprox
Anaprox DS
Ansaid
Arthrotec
Aspirin
Bextra
Bufferin
Butazolidin
Cataflam
Celebrex
Clinoril
Darvon Compound-65
Daypro
Diclofenac
Diflunisal
Disalcid
Dolobid
Empirin
Empirin with Codeine
Etodolac
Excedrin
Feldene
Fenoprofen
Flurbiprofen
Ibuprofen
Indocin
Indocin SR
Indomethacin
Ketoprofen
Ketoralac
Lodine
Lodine XL
Lortab ASA
Meclofenamate
Mobic
Motrin
Nabumetone
Naprelan
Naprosyn
Naproxen
Naproxen Sodium
Orudis
Oruvail
Oxaprozin
Oxycodone and Aspirin
Percodan
Phenylbutazone
Piroxicam
Propoxyphene, Aspirin and Caffeine
Propoxyphene Compound-65
Relafen
Roxiprin
Salsalate
Sulindac
Talwin Compound
Tolectin
Tolectin DS
Tolmetin
Toradol
Trilisate
Vicoprofen
Vioxx
Voltaren
Voltaren XR
Zomax
Zomepirac

(Note: Some medications containing nonsteroidal anti-inflammatory drugs may not be listed here. If you have any questions as to whether or not you're taking a medication that may have aspirin or another nonsteroidal anti-inflammatory medication as an ingredient please check with your doctor or a pharmacist.)