Before any operation, the medical assessment matters more than anything else, and it comes down to practical questions. Which of your tablets do you keep taking, which stop and how many days before, what does smoking actually change, and what has to be settled before a date is worth booking. You will find most of your answers here, and if you want more detail on anything, you can ask me directly.
Every line in the result is there because of something you answered. Nothing that does not apply to you is shown.
Nothing is saved to a file or an account, and no answer reaches me unless you choose to send the summary yourself.
It does not decide whether you are suitable for surgery. That decision is mine, after I have seen your photographs and your history.
Pick the procedure you are considering, then work through the seven steps.
Seven steps, about five minutes, and nearly every answer is a single tap. At the end you get a short list of what to deal with first, the points we should talk through before you fly, a preparation timeline counted back from your surgery date, and a sheet you can print and take to your own doctor.
Your answers stay in this browser. Nothing you tick here is saved to a file or an account, and no answer reaches me unless you choose to send the summary yourself at the end.
The medication and smoking guidance in this tool follows published perioperative literature. Sources are listed below so your own doctor can check them.
This tool prepares your consultation. It does not replace one and it cannot decide whether you are suitable for surgery. That decision is made by Dr Mustafa Aydinol after seeing your photographs and your medical history.
Above, the check shows only the items that apply to your own answers. Below is the complete list, so you can read anything that is relevant to you before we speak. It is the same text, not a summary of it.
Thank you for telling me, and I am sorry that this is my answer. I do not perform elective aesthetic surgery in patients who are HIV positive. This is my own limit as a surgeon, and I want to be clear about what it is not. It is not a judgement about you, and it is not a claim that the operation would go badly: in people on treatment with an undetectable viral load, the perioperative literature does not show worse surgical outcomes. I would still rather write it plainly here than let you send photographs, arrange time off and book flights, and hear it from me later. Aesthetic surgery is performed in HIV positive patients in larger hospital units that have infectious disease cover on site, both in Turkey and in your own country. You do not have to work this out on your own. Message me, tell me which country you are in and what you were considering, and I will point you towards surgeons and units I would trust with it. I would rather hand you on properly than leave you searching.
Elective aesthetic surgery is not performed during pregnancy. Nothing here is urgent and everything on this page will still be true afterwards. Come back to it once you have had your baby and your weight has settled.
A previous heart attack, a rhythm problem or a conduction block changes how anesthesia is planned and monitored. Before we set a date, see your own cardiologist and ask for written clearance for elective surgery under general anesthesia, with a recent ECG and, if they think it is needed, an echocardiogram. Bring the report and the list of your heart medicines with doses.
A previous clot puts you in a higher risk group for the whole operation, not just the day of it. Before we set a date, see the doctor who managed that clot and ask for written clearance and their advice on prevention around surgery. Tell me when it happened, how it was treated, and whether a cause was ever found.
A blood or clotting disorder is one of the few things that genuinely changes whether and how an elective operation should be done. See your hematologist before we set a date and ask for written clearance, including what should happen with your treatment around surgery. Bring recent blood counts and clotting studies.
This combination deserves a separate line. You are considering facial surgery while taking something that affects bleeding, and bleeding under the skin is the most common early complication of a facelift, with high blood pressure and male sex recognized as added risk factors. It is not a reason to abandon the operation. It is the reason we settle the medicine and your blood pressure before a date goes in the diary, rather than discovering the problem on the morning.
These two are the factors that show up most consistently in body contouring complication data, and you have both. In one series of tummy tucks after major weight loss, diabetes was the strongest independent predictor of complications; in a series of 100 lower body lifts, smoking was the only factor significantly linked to them. They act on the same thing from two directions: the oxygen reaching a fresh wound edge. In practice this means your wounds may take longer to close than the timelines you read online, that I want your blood sugar control settled and a supported quit program started for the nicotine before we book a date, and that if healing does run slow afterwards, hyperbaric oxygen is a treatment we can add. It is used for wounds that are not healing and for skin under strain, not as something every patient needs.
Nicotine narrows the small vessels that feed a healing wound. Smoking on the day of surgery is independently linked to wound infection. The timing news is better than you expect. The quit programs tested in trials ran four to eight weeks before the operation. Longer abstinence means fewer chest and wound problems. But stopping at any point, before or after surgery, carries no increased complication rate. A quit shorter than four weeks has not been shown to make anything worse, which is the opposite of what most people are told. There is also a less comfortable finding. Being told to stop is not the same as being helped to stop. Supported programs with weekly contact roughly halved complications after surgery. Brief advice on its own raised quit rates but did not measurably change complications. So this page is brief advice, not a supported program, and I cannot run a supported program for you from Istanbul. Ask your own doctor, a pharmacist or a national quitline for a supported program. Use nicotine replacement if you want it. It is safe around surgery and does not harm wound healing once you have stopped. A patch plus a fast acting form, gum or a lozenge, works better than a patch alone. If you are not ready to quit for good, quit for a bit: nothing from the morning of surgery until at least a week afterwards, in the same way you fast from food. I do not postpone surgery because you smoke, and I will not pretend a four week quit is realistic for everyone.
You told me vape or pouches rather than cigarettes, so you deserve the honest answer for that. The perioperative consensus is that there is not enough evidence to say whether these are safe or effective around an operation. Outside surgery they do help some people stop smoking. In one trial the one year quit rate was 18 percent with them against about 10 percent with nicotine replacement. Around surgery nobody has measured what they do to complication rates. So I will not tell you that switching has solved the problem for your wound. I will not tell you it is the same as smoking either. Neither claim is supported. What is not in doubt is that nicotine itself narrows the small vessels that feed a healing wound. If you can be off nicotine altogether in the weeks before the operation, that is the version I would choose, and licensed nicotine replacement is the better studied route. Tell me what you use and how much. If you are not stopping, treat the morning of surgery and the first week afterwards as nicotine free, in the same way you fast from food.
Regular drinking above about three drinks a day is linked to more infections, bleeding and heart and lung problems after surgery. In pooled trials, an intensive program to stop drinking for four to eight weeks before an operation reduced complications, although that evidence rests on three small studies. Cutting down well before your date is worth more than stopping the night before, and tell the anesthesiologist honestly how much you drink, because it changes the doses they use.
Old scars in the operating area change the blood supply and the plan, and they do not always show up clearly in photographs. Tell me what the operation was, roughly when, and whether mesh was used. If you can still find an operation note or a discharge summary, bring it, but do not worry if it was years ago or in another country. What you remember is enough to start with.
Tell me which operation you had and when. After a sleeve or a bypass the things that matter for healing are protein intake, iron, vitamin B12 and vitamin D, and whether your weight has been stable for long enough. Bring your most recent blood results, including a full blood count, ferritin and B12.
Age on its own does not rule anything out, but past sixty I want an anesthetic assessment before we set a date rather than on the morning of surgery. Bring your recent blood pressure readings and an ECG if you have had one in the last year.
This matters more than most people expect. In a series of 121 tummy tucks after major weight loss, diabetes was the strongest independent predictor of complications, ahead of body weight itself. It does not rule surgery out, it means your blood sugar control needs to be good before we book a date. Bring a recent HbA1c.
A recent TSH result is the thing I would most like to see. Thyroid medicine is not a drug we stop for surgery, and the aim is simply to have your levels in range before an elective operation. An untreated or poorly controlled thyroid affects blood pressure under anesthesia, bowel movement afterwards and blood counts, which is why the number matters more than the diagnosis.
Tell me when your last seizure was, how often they happen and what usually sets one off. Epilepsy does not stop an elective operation, but it changes what the anesthesiologist plans for, and the things that surround surgery, a disturbed night, fasting, missed doses and stress, are exactly the triggers most people already know about. This is not a detail to leave until the morning.
Bring your inhalers and tell me how well controlled your breathing has been over the last few months. A chest infection in the weeks before surgery is a reason to move the date, not to push through.
Tell me exactly what happens with each allergy, because a rash and a swollen throat are two very different things for the anesthesiologist. Antibiotic allergies matter most, since we give an antibiotic before the operation starts. An adhesive allergy is worth knowing before surgery rather than after, because dressings and tape stay on for days.
Anemia before surgery is common and is an independent risk factor for problems afterwards, and the usual cause is iron deficiency, which is correctable. This is one of the few things on this list you can fix completely before you fly, but it needs weeks rather than days. Get a full blood count and a ferritin level done now and send me the results.
You should also know this in advance, because nobody likes hearing it on the morning of surgery. Being anemic does not by itself rule out an operation. It does mean that if we go ahead without correcting it, the chance of needing a blood transfusion during or after surgery is real rather than theoretical, and you would be asked to consent to that. In the published series of combined body contouring after weight loss, patients were only accepted for surgery with a hemoglobin above 10, and iron replacement beforehand is the reason most of them never needed transfusing. Correcting the iron first is almost always the better trade.
Heavy periods are the commonest reason for low iron in women, and it often goes unnoticed because it comes on slowly. Ask for a full blood count and a ferritin level, not just hemoglobin.
Good, keep taking it. Bring the dose and tell me when you started, because iron takes weeks to raise hemoglobin and the timing of your surgery depends on where that number is now, not on the fact that you are taking something.
Thank you for telling me. Hepatitis B does not change whether your operation can be done. The operating room already works to the same protection standard for every patient, so nothing about your care changes. Bring your recent results and the name of any medication you take for it.
Thank you for telling me. For hepatitis C I ask for one specific thing before surgery: an HCV RNA test showing the virus is undetectable, taken within the last six months. Bring that result, along with your liver function tests and the details of any treatment you have had.
Loud snoring can be a sign of sleep apnea, which is common and usually undiagnosed at the time of surgery. It matters because the sedatives and painkillers used around an operation act on the same breathing control that apnea already disturbs. Mention it to the anesthesiologist even if nobody has ever tested you.
Someone has seen you stop breathing in your sleep, and that is the single most useful sign of sleep apnea. Roughly one in four people coming for elective surgery has it and more than eight in ten of them do not know. Left unrecognized, it is independently linked to a higher rate of breathing problems and complications after an operation. Before we set a date, see your own doctor and ask about a sleep study. If you already use a CPAP machine, bring it with you to Istanbul.
A clotting problem in the family changes the precautions I take, and sometimes it is worth being tested before an elective operation. Tell me who it was, how old they were, and whether a cause was ever found.
Some serious reactions to anesthesia run in families. Tell me what happened and to whom, and if any anesthetic record exists, bring it. The anesthesiologist can plan around it easily when they know in advance.
Never stop these on your own, and do not assume the answer is simple. In major general surgery the usual advice is to keep going, because a clot is worse than a bleed. In elective aesthetic surgery the balance is reversed: the operation is optional, and bleeding is the thing most likely to spoil it. A 2025 systematic review of aesthetic surgery found no agreed standard at all, with stopping 48 to 72 hours beforehand advised for higher risk operations such as a facelift, and continuation considered acceptable in some lower risk work such as eyelid surgery. Its conclusion is the one I follow: because these operations are elective, safety comes first. So we plan the timing with the doctor who prescribes it, and if it turns out you cannot come off it safely, we postpone the operation rather than accept the risk. Stopping one of these early on your own carries its own danger, roughly a one in ten risk of a vascular event, which is exactly why this decision is not yours or mine to take alone.
Your surgery date is {n} days away and you are taking aspirin or a blood thinner. Whether it is paused before an operation, and how many days before, is normally planned about a week to ten days ahead, so this is the one thing on this page that cannot wait. Contact the doctor who prescribes it now, before you travel. Do not stop it by yourself. If you take it because of a heart condition, a stent, an irregular heartbeat or a previous clot, stopping it can be more dangerous than the surgery itself, and that decision belongs to them.
Supplements are the one group here where the usual advice is to stop rather than to continue, because most of them have never been tested around surgery and there is little to lose by pausing something with no proven benefit. The perioperative consensus holds most herbal supplements for two weeks before the operation, and the list is longer than people expect: garlic, ginkgo, ginseng, ginger, turmeric, saw palmetto, feverfew, horse chestnut and vitamin E are all on it, mostly because of bleeding. Glucosamine and chondroitin clear faster and need only 48 hours. Two of these surprise people. Fish oil and omega-3 are now continued rather than stopped, because the old bleeding concern was not confirmed in prospective studies. St Johns wort still needs the full two weeks, not for bleeding but because it changes how your body handles several other drugs. Probiotics, magnesium and other minerals, and vitamins other than vitamin E at normal doses are a different matter: none of them is on the bleeding list and none needs a two week gap, so they carry on. If what you take is a multivitamin or a combination product, the whole product is held when any single ingredient is on the hold list, which is why I ask for the actual box rather than a category. CBD and cannabis products belong in this answer too, and the consensus is not to use them before surgery. If you arrive still taking one of these, it does not automatically cancel anything: for smaller work we usually go ahead with extra care, and for an operation where bleeding would spoil the result, moving the date is the honest answer.
These are easy to forget because they are sold without a prescription, but taken regularly they affect how platelets work and therefore how much you bleed and bruise. Tell me what you take and how often. The consensus figure is to stop this group seven days before surgery, though several of them clear much faster than that and a shorter gap can be agreed drug by drug: ibuprofen and diclofenac need about a day, naproxen about four. Celecoxib is the exception. It does not affect platelets at all and is continued right up to and including the day of surgery, which is often the simplest answer if you need something for pain in that last week. If you use these for a chronic pain problem we will plan an alternative for the days around surgery rather than leaving you with nothing.
These raise clotting risk around surgery, but stopping them is not automatically the safer choice. The perioperative consensus is to continue them before and on the day of surgery, weighing the clot risk against the risk of an unplanned pregnancy if they are stopped, and the four week cessation printed on some packet inserts comes from general population data rather than from surgical studies. Among surveyed plastic surgeons, only about a third stop the pill at all. If what you take is menopausal hormone therapy, two things work in your favor. It contains far less estrogen than the pill, and the same consensus lists estradiol and progesterone as medicines to continue, before and on the day of surgery. The form matters as well: in a large UK database study, estrogen through the skin, as a gel or a patch, was not linked to a higher clot risk at all, while estrogen tablets were, and the risk differed between progestogens, with medroxyprogesterone the highest. So a gel or a patch with a progesterone capsule is usually continued, and stopping becomes a question only if you have other clot risk factors on top. Either way this is a decision to make with the doctor who prescribes it, and it does not replace the measures that matter more: compression, hydration and getting you walking on the same day.
Thank you for telling me, and this is the item on the page with the longest lead time, which is exactly why I ask about it. Naltrexone blocks painkillers. As a daily tablet it is stopped a few days before surgery when painkillers are expected afterwards. As a monthly injection or an implant the block lasts far longer, and surgery is planned roughly 24 to 30 days after the last dose. That is not something that can be arranged in the week before you fly. Buprenorphine is a different and more nuanced case: current thinking leans towards continuing it through surgery rather than stopping, adding a stronger painkiller on top if pain is not controlled, but the right answer depends on your dose and on why you take it. None of this is decided here. It is agreed between the doctor who prescribes it and the anesthesiologist. Send me the name, the dose, and the date of your last injection if it is an injection.
This group needs specific attention and most patients have never been told why. These tablets can cause a form of ketoacidosis while the blood sugar reading still looks normal, which is easy to miss around an operation. What to do about it has genuinely changed. The regulators and most national guidelines still say stop the tablet 3 days before surgery, 4 days for ertugliflozin. The 2026 consensus statement, built on a systematic review, replaces that blanket rule with a tailored one, because stopping also costs you the heart and kidney protection these drugs give. In broad terms it says: for minor procedures, keep taking it; for bigger operations, keep taking it if you do not have type 2 diabetes, or if you have diabetes together with heart failure or kidney disease; stop it three or four days ahead if a long fast after surgery is expected. Two things drive the risk more than the tablet itself: long fasting and low carbohydrate eating. So tell me the name of the tablet and why you take it, whether for diabetes, for your heart or for your kidneys, and we will agree the plan with your prescriber.
This one matters for you specifically. Crash dieting or low carbohydrate eating while taking an SGLT2 tablet is the combination most often behind ketoacidosis before surgery, and many people diet hard in the weeks before an operation. The consensus is explicit: if you have type 2 diabetes and you are starting a very low carbohydrate diet, the tablet is stopped when the diet starts, not three days before surgery. Do not start a strict diet before we have talked about this.
Start from the good news: the device usually stays on. The perioperative consensus is that a glucose sensor is kept in place through the operation, and an insulin pump can be kept running for most day case surgery, agreed with the anesthesiologist. What it does not do is decide anything by itself. Your blood sugar is still checked by fingerstick every one to two hours during the operation, whatever the sensor says, so nothing depends on me being able to open your app. Three things I need from you before you book flights. First, the report your sensor app produces for the last 14 days: average glucose, time in range, time below 70 and the GMI figure. A screenshot on WhatsApp is enough. This matters more than it sounds, because a low iron level makes an HbA1c reading unreliable, and low iron is common in the patients I operate on. Second, your pump settings: basal rates, correction factor and which insulin is in it. Third, where you wear the sensor and the cannula, because both need to sit away from the operating area and off any point you will be lying on. Two timing points then follow. Your surgery date should not land on the first or the last day of a sensor session, since the readings drift at both ends, and you will be scheduled as the first case of the day so you are not fasting into the afternoon. Bring your own supplies, sensors, infusion sets, cartridges and chargers, because hospitals do not stock these. One last thing worth saying plainly: if you would rather not manage the pump yourself afterwards, or if we cannot run through the buttons with the anesthesiologist beforehand, we simply plan insulin through the drip instead. That is a normal plan, not a failure, and it is decided in advance rather than on the morning.
Bring it with you to Istanbul in its original box, with the doses written down, and bring your glucose meter. Do not adjust anything yourself for the fasting morning, but so the plan is not a surprise: long acting background insulin is normally continued, often at a slightly reduced dose the evening before, fast acting mealtime insulin is held on the morning because you are not eating, and most diabetes tablets are taken as usual until the day before and then skipped on the morning. The hospital team gives you the exact version of that, and they can only do it if they can see precisely what you are on.
Steroids and immune-suppressing medicines are among the few drug groups that act directly on wound healing and on your ability to fight infection, so I need the full picture: the drug, the dose, how long you have been on it and when your last dose of any injected biologic was. Do not stop or skip anything yourself, because a flare of the disease before surgery is its own problem. The consensus recommendation for long term steroid tablets is to continue them before and on the day of surgery, with the possibility of a higher dose being given during the operation itself. The good news is that most of the tablets are continued: methotrexate, hydroxychloroquine, sulfasalazine, leflunomide and apremilast are all taken as normal, including on the morning of surgery. Steroid tablets are continued too, but the dose matters. Infection risk rises with the dose rather than with the fact of taking them, so where it can be done safely the aim is to be on the lowest dose that holds your disease before we operate. If you have been on more than 5 mg a day for over a month, the anesthesiologist may give extra steroid cover during the operation itself. Injections are the ones timed around the date. The rule is to miss one full dosing cycle and to operate in the week the next dose would have been due, so a fortnightly injection means surgery in week three, and one you take every twelve weeks means week thirteen. The newer JAK inhibitor tablets, such as tofacitinib, stop only three days before. Afterwards, injections usually restart at about two weeks if the wound is healing cleanly, and the JAK inhibitor tablets after three days. None of this is decided here. It is agreed between your rheumatologist or dermatologist and the anesthesiologist, and I need the date of your last injection to work backwards from.
Take it as usual up to the day before, but not on the morning of surgery. The reason is mechanical rather than anything to do with bleeding: these tablets can irritate the gullet if you lie down soon after swallowing them, and anesthesia relaxes the valve at the top of the stomach.
Not while you are breastfeeding. Breast and abdominal results change as feeding stops and the tissue settles, and operating before that means operating on a shape that is still changing. Once feeding has finished and your weight and shape have been steady for a few months, send me photographs and we will plan.
If a pregnancy is likely within the next year, an abdominal or breast result done now will be undone by it. That is a timing decision rather than a medical barrier, but it is worth thinking about before you book flights.
A long flight and recent surgery pull in the same direction, and the risk sits mainly with people who already have other risk factors. Graduated compression stockings are the measure with real evidence behind them on longer flights, so wear them in both directions. Walking in the cabin and drinking water are not well proven but cost nothing and make sense. Do not book a fixed return flight without agreeing the date with me.
Under five days is tighter than the usual plan and it is the part I would want to talk about before you book. Keep the return flexible if you can, because the date that suits your healing is easier to judge after surgery than before it.
Two separate issues here, and the second one has changed. For the result: your weight needs to have settled, or the body you wake up with keeps changing under the scar. For anesthetic safety: these drugs slow the stomach, so food can still be sitting there after normal fasting, and that is what causes the rare but serious problem of stomach contents entering the lungs during anesthesia. Earlier advice was to stop the injection for a week or more before surgery. The 2025 consensus statement, built on a systematic review, goes the other way: keep taking it, and change the fasting instead. Its recommendation for someone without significant symptoms is clear liquids only for the 24 hours before surgery, no high sugar drinks in the last 8 hours, and nothing at all except water or similar in the last 4. If you have severe nausea, vomiting or cannot keep food down, that is different: those patients should not go ahead until their own prescriber has adjusted things. Feeling full or getting full quickly does not count as a severe symptom. Do not change your dose on your own. Tell me the drug, the dose and the date of your last injection.
Bring the names and doses, and bring the boxes with you to Istanbul. Most of this group is continued, including on the morning of surgery: beta blockers, where stopping suddenly is more dangerous than the operation, calcium channel blockers, clonidine, which causes rebound high blood pressure if stopped, hydralazine, thiazide type water tablets, spironolactone, digoxin, nitrates and rhythm medicines. Three groups are held on the morning instead: the ACE inhibitors (ramipril, lisinopril and the rest of that family), the sartans (losartan, valsartan and the rest), and loop water tablets such as furosemide. The combination of sacubitril with valsartan is held too. One trap worth knowing: if your tablet combines two drugs and one of them is on the hold list, the whole tablet is held, so a combination pill needs naming precisely. The hospital anesthesiologist gives the final instruction, and whatever is paused goes back as soon as you are eating and drinking normally, because not restarting these afterwards is its own risk.
Do not stop or skip these. A multidisciplinary consensus statement on preoperative management of medicines for neurological conditions concludes that, as a general rule, they are continued before surgery, with an individual decision only in specific situations such as brain surgery where the electrical activity is being mapped. Missed doses around an operation are one of the avoidable causes of a seizure. Some of these drugs also interact with the ones the anesthesiologist uses, and a few need blood levels checked beforehand, which is why the names and doses need to be on the record well before the day.
Do not stop this before surgery. Antidepressants and antipsychotics are continued through the operation, because stopping brings its own problems: discontinuation symptoms and a higher chance of confusion after surgery. One study did link SSRI use to needing blood products more often in high bleeding risk operations, but nobody has shown that stopping helps, so the sensible course is to keep taking it and tell the anesthesiologist.
Keep taking it, including on the morning of surgery. A multidisciplinary consensus statement on preoperative endocrine medication is explicit here: thyroid replacement is continued without dose adjustment both before and on the day of surgery, and the usual dose can be swallowed with a sip of water. Bring a recent TSH as well, because an elective operation is best done once your levels are in range.
Keep taking it, and do not miss a dose. The consensus recommendation is that antithyroid medicines are continued uninterrupted, before and on the day of surgery, specifically to avoid a thyroid storm around the operation. Bring a recent TSH and free T4, because an elective operation should wait until your levels are in range.
Keep taking them, including on the morning of surgery. This is the one people most often get wrong on their own, because cutting down before an operation feels like the responsible thing to do. It is not. Stopping or reducing shortly beforehand does not lower what you will need afterwards, it raises your pain going in, and higher pain before surgery predicts higher pain after it. If a reduction is genuinely right for you, it is planned slowly with your own prescriber, no faster than about ten percent a week, and for your own reasons rather than because of the operation. What I need is the exact drug and dose, because taking these long term means you will need more than the usual after surgery, not less, alongside the non-opioid part of the plan. Paracetamol carries on as normal too. Three details matter if they apply to you. Codeine and tramadol only work once your liver converts them, and several drugs used around an operation block that conversion, so the anesthesiologist needs to know. If you wear a fentanyl patch, say where on your body it sits, because the warming blanket used in the operating room makes a patch release faster than it should. And if your kidneys are not perfect, some of these are a poor choice and we would plan differently.
Two different answers here, so tell me which one you take. Triptans, the sumatriptan family, carry on as normal up to the day before but are not taken on the morning of surgery, because of how they interact with several drugs used in the operating room. Ergotamine needs longer, at least two days, since combined with anesthetic drugs it narrows blood vessels more than it should. The newer preventive injections, the ones given monthly or every three months, are the easy case: they carry on unchanged and the operation can fall on any day of the cycle, including the day of an injection. If a headache starts on the morning of surgery, tell the team rather than reaching for your usual tablet, because there are safer options on the day.
These split into two groups and the difference matters. Baclofen and tizanidine are continued, including on the morning of surgery, because stopping them suddenly causes withdrawal problems of its own, and with baclofen that can be serious. The rest, cyclobenzaprine, methocarbamol, metaxalone, orphenadrine and carisoprodol, are held on the morning of surgery, because they add to the sedation from the anesthetic. Carisoprodol is the one to flag early: if you take it daily it should be tapered over roughly a week rather than stopped abruptly. Tell me the name and how long you have been taking it.
Bring your inhalers in your hand luggage and use them as normal, including on the morning of surgery. That goes for all of them: relievers, preventers, steroid inhalers and the combination ones. Montelukast tablets carry on as well. The one exception is theophylline, which is taken up to the day before but not on the morning of surgery, because it has a narrow safe range and interacts with several drugs used in the operating room. Tell me the names, because a reliever used more than a couple of times a week suggests your asthma is not as settled as it feels.
Keep taking it as normal, including on the morning of surgery. Omeprazole and the rest of that family, and famotidine, are all continued, because reflux left untreated around an operation causes more trouble than the tablet does. Liquid antacids are the exception: take them up to the day before, but not on the morning of surgery. If you have been on an acid tablet for years, there is one thing to check. They reduce how well you absorb iron and vitamin B12, which is a quiet cause of low blood counts, so ask for a ferritin level and a B12 alongside your full blood count.
Keep taking them as usual, and bring the box so the name and dose are on the record. These medicines add to the sedation the anesthesiologist gives you, which is a reason to tell them, not a reason to stop. The perioperative consensus for psychiatric medicines is explicit for the benzodiazepine group, temazepam, lorazepam, diazepam and their relatives: continue them, including on the day of surgery, because stopping suddenly brings withdrawal and rebound sleeplessness, and someone who takes one regularly often needs more anesthetic rather than less, which the anesthesiologist plans for. Zolpidem and the related sleeping tablets are not listed separately in that consensus, and the sensible course is the same: take your usual dose the night before if you normally do, and say so. The newer orexin blockers, daridorexant, suvorexant and lemborexant, work in a different way from the older tablets. In a randomized trial, suvorexant was given every night for up to a week after heart surgery with no more side effects than placebo, so there is no reason to stop them: take your usual dose and tell the anesthesiologist. Two things to avoid: do not take an extra tablet because you are nervous the night before, and do not combine any of these with alcohol in the days before or after surgery. Melatonin and valerian are the simple ones: the supplement consensus says both can continue. Kava is the exception and is stopped two weeks before, because it adds to the sedation of the anesthetic.
Worth telling me even though it feels unrelated, because a lot of men leave it out. These medicines widen blood vessels, and combined with anesthesia that can drop your blood pressure at the wrong moment. Two consensus statements from the same group give slightly different timings when the drug is taken for erectile difficulty or prostate symptoms: one says stop it at least 24 hours before, the other says three days. Tadalafil lasts the longest, so it is the one that needs the longer gap. If instead you take it for high pressure in the lungs, that is a different situation entirely and it is continued without interruption, so tell me which it is.
This list is general. It does not replace the instruction your own prescriber or the hospital anesthesiologist gives you for your specific dose and date.
The medication and smoking guidance follows published perioperative literature, and every source is listed at the bottom of your result so your own doctor can check it. Below the tool you will also find the full reference: every item this check can raise, whether or not it applied to your answers.
If you already have a surgery date and want a day by day plan for afterwards, the recovery planner builds one.
So the right person on our team can answer you.
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