Medical procedures require attention to food, drugs

Somewhere in that sheaf of letters, permissions and schedules you receive before going in for a medical procedure will be a particularly baffling set of instructions.

So why are you ordered to avoid certain drugs — and even a few innocent-seeming foods and spices — before having a medical procedure?

Because, it turns out, some prescription and over-the-counter drugs, some food supplements and even some foods and spices can pose the risk of interfering with the procedure itself, create risks during the procedure or impair healing.

Joseph McCoy, a doctor of pharmacy and assistant professor of pharmacy practice at the Roseman University of Health Sciences College of Pharmacy, said most such restrictions represent ways to reduce risks related to bleeding, dangerous blood pressure changes, cardiac events or — particularly in the case of major surgeries — deep vein thrombosis, or blood clots.

Among the most common drugs patients will be asked to avoid taking before a medical procedure will be such nonsteroidal anti-inflammatory drugs as aspirin, ibuprofen (also sold under the brand names Advil and Motrin) and naproxen (sold under the brand name Aleve). All can make it more difficult for blood to clot and, McCoy says, “can have the potential to delay wound healing as well.”

Among other types of drugs for which dosing might be altered before surgery or a medical procedure are anti-coagulants or so-called “blood thinners” (such as warfarin, also known as Coumadin), insulin and such diabetes drugs as metformin, and such hypertension drugs as diuretics and ACE inhibitors, McCoy says.

Besides prescription and over-the-counter drugs, preprocedure prohibitions also might be placed on some vitamins, nutritional supplements, herbal supplements and spices that can cause potentially adverse effects similar to their prescription cousins. These include St. John’s wort, ginkgo biloba, ginseng, vitamins C and E, cumin, garlic, ginger and turmeric.

The bottom line is, first, to make sure your doctor knows about everything — prescription drugs, over-the-counter drugs, supplements, vitamins, herbal preparations — you’re taking, and ask your doctor if you’re not sure what to do before a procedure.

Second, read the information given to you, and follow the directives to the letter, for as long as you’re told to.

And, always: Don’t start taking, stop taking or change the dosing of anything you are taking without talking to your doctor.

“I don’t think people really give it much consideration,” McCoy says. Particularly in the case of over-the-counter and herbal supplements, “they simply don’t realize what these ingredients do.”

Contact reporter John Przybys at jprzybys@reviewjournal.com or 702-383-0280.