What Medications Are You Taking?

g Herbal medicine or botanicals are increasingly popular. And while medical doctors do not necessarily object to their patients ingesting these non-prescription products, patients undergoing surgery are advised that:

“There have not been enough studies of botanicals in the U.S. for us to state that there definitely will or will not be a reaction during surgery, but most anesthesiologists and surgeons will err on the side of caution…we recommend discontinuing some herbal medications at least two to three weeks prior to surgery.”*

What particularly concerns me and other surgeons is that patients taking these substances often do not regard them as medicines, so when asked, “What medications are you taking,” the patients frequently do not reveal that they are taking these products. According to the American Society of Anesthesiologists, “Seven out of 10 people using these will not tell their physicians.” Our practice’s unswerving routine is to raise the subject with all patients, at the “preoperative visit,” several weeks prior to the surgery date and give them the following list of the more common herbal medications and their potential complications that could arise during surgery.**

Ginseng

Ginseng is used to enhance energy levels. If combined with stimulants used by anesthesiologists, it can cause tachycardia and high blood pressure. It can also decrease the effect of Warfarin, causing the blood to thicken and develop clots.

Ephedra

Ephedra is included in over-the-counter diet aids. It interacts with inhalants used for anesthesia to affect blood pressure. If used with monoamine oxidase inhibitors or Oxytocin, the patient can experience high blood pressure and irregular heart rate during surgery.

Feverfew

Feverfew is often used to treat migraines. It inhibits platelet activity that can increase bleeding during surgery.

Valerian

Valerian is a mild sedative to help sleep. It causes a potential increase in the effect of barbiturates used in anesthesia, which causes a deeper effect of anesthesia.

Ginkgo Biloba

Ginkgo Biloba is a circulatory stimulant. It decreases platelet activity and clotting ability.

St. John’s Wort

St. John’s Wort is used to treat anxiety and depression. It may prolong the effects of some narcotics and anesthetics.

Licorice

Licorice treats symptoms of gastritis and duodenal ulcers. It can cause edema and chronic liver problems and increase the risk of renal insufficiency.

Echinacea

Echinacea is used to enhance the immune system; it may cause hepatotoxicity and possible liver damage.

Ginger

Ginger treats nausea. It can increase bleeding time.

Goldenseal

Goldenseal is a diuretic and laxative. It can worsen edema and increase blood pressure.

*.Jessie A. Leak, M.D., Associate Professor, Department of Anesthesia, M.D. Anderson Cancer Center, Houston, a researcher who specializes in the study of herbal medication.

**Compliments, Jessie A. Leak, M.D.

Herbs, Foods, Spices, and Medications to Be Avoided for at least Two Weeks before Surgery

Absorbine

Bog bean

Feldene

Percogesic

Absorbine Jr.

Boldo

Fenugreek

Peristin

Acodeen-30

Borage Seed Oil

Feverfew

Plantain

Braska

Fiogesic Tablets and Capsules

Poplar

Advil

Bromelain

Fiorinal Capsules and Tablets

Quassia

Agrimony

Buff-A-Comp

Fish Oils

Red Clover

Alfalfa

Buffadyne

Fucus

Rid-A-Pain

Alka-Seltzer Extra

Bufferin-All Varieties

Garlic

Robaxisal

Strength

Butalbital

Ginger

Roman Chamomile

Alka-Seltzer

Cama-Inlay Tabs

Ginkgo

Roxiprin

Flavored

Capsicum

Ginseng

Rumarub

Alpha Phed Capsule

Carisoprodol

Glepirin Tablets

Safflower

Anacin Analgesic

Celery

Goldenseal

Sine-Aid

Caplets and Tablets

Clove

Heet

Sine-Off

Chloracol Capsules

Horseradish

SK–65 Compound Capsules

Anacin Maximum

Clinoril

Ibuprofen(Mortrin, Nuprin, Advil, Anaprox)

Solan’s

Strength Analbalm

Congespirin

Icy Hot

Soltice

Analgesic Balm

Compound

Indocin

Soma Compound (or with Codeine)

Angelica

Cope

Infra-Rub

SPD Stendin

Anise

Coricidin

Licorice

Southern prickly ash

Effervescent

Counterpain Rub

Lini-Balm

Stinging nettle

Anti acids and

Damason

Lortab ASA

Supac Surin

Pain Reliever

Danshen

Meadowseet

Sweet Clover

Anti phiogistine

Darvon with AsjA

Mentholatum

Sweet Vernal

4-Way Cold Tablets

Darvon-N with ASA

Meprobamate and Aspirin Tablets

Synalogos DE Capsules

A.P.C.

Dencorub

Midol

Talwin

Diet Pills

Monaceet with Codeine

Tolectin

Arthralgen

Di-Gesic Improved

Morgesic

Tonka bean

Arthritic

Doan’s Rub

Musterole

Traminicin

Arthritis Pain Formula

Dolprin 33

Naprosyn

Turmeric

Asafoetida

Dong quai

Northern prickley ash

Vanquish

Ascriptin with

Dristan

Neurabaim

Vitamin E

Aspen

Surgaesic

Norgesic Forte

Voltaren

Codeine Tablets

Easprin

Oil-O-Sol

Yager’s Liniment

Aspercreme

Ecotrin

Omega Oil

Yarrow

Axotal

Empirin with Codeine

Orphengesic

Zomax

Bac #3

Emprazil

Oxycodone

Zorprin

Bac Tablets

Emul-O-Balm

Pabirin Buffered Tablets

Banalg

End-Ake

Panalgesic

Baumodyhne

Equagesic

Papain

Bayer Aspirin Varieties

Esotrin European Mistletoe

Passionflower Pau d’ Arco

BC Powders

Excedrin Extra

Pepto-Bismol

Black Cohosh Ben Gay

Strength Exocaine

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