Why You Must Tell Us What Medication You Take

One of the first questions we ask during an anesthesia assessment is this: "Do you take any medication regularly?"

That question matters more than most people expect. Knowing every drug a patient takes is one of the basic conditions of safe anesthesia planning.

We are not talking only about prescription drugs. Vitamins, herbal products, sports supplements and even products regarded as "natural" can affect anesthesia and the course of surgery.

Anesthesia is not just putting you to sleep

Anesthesia is often understood as sending the patient to sleep. Modern anesthesia is a complex process that involves:

• Controlling consciousness
• Preventing pain
• Managing breathing
• Protecting the heart and circulation
• Providing muscle relaxation

The drugs you take can therefore affect every stage of it.

Some drugs increase the risk of bleeding

Blood thinners are among the drug groups we pay most attention to before surgery. For example:

• Aspirin
• Clopidogrel
• Ticagrelor
• Prasugrel
• Warfarin
• Rivaroxaban
• Apixaban
• Dabigatran

These can increase bleeding during surgery.

There is an important point here: no patient taking a blood thinner should stop it on their own. In some patients, continuing the drug is safer than stopping it. The decision must always be made together by the surgical team and the anesthesiologist.

Diabetes medication can affect anesthesia

Drugs used in diabetes may require specific planning before surgery, particularly:

• Insulins
• Metformin
• SGLT-2 inhibitors
• GLP-1 agonists (Ozempic, Mounjaro, Wegovy and similar)

GLP-1 drugs, which in recent years have also been used for weight loss, can slow gastric emptying and therefore carry particular importance for anesthesia.

Should blood pressure medication be stopped?

There is no single answer. Some blood pressure drugs should be taken on the morning of surgery; for others the advice differs.

The approach of "I will skip my pill this morning, I am having an operation anyway" is not correct. The plan can be different for each drug you take.

Psychiatric medication must always be reported

Drugs used for depression, anxiety or other psychiatric conditions matter too. For example:

• Antidepressants
• Anti-anxiety medication
• Sleeping tablets
• Mood stabilisers

These can interact with anesthetic drugs. In most cases they do not need to be stopped, but they must be known for the plan to be made correctly.

Vitamins and herbal products are not harmless

Many patients do not think of herbal products as medication. Yet some supplements can cause serious problems during surgery.

Garlic supplements

Can increase the tendency to bleed.

Ginkgo biloba

Can act as a blood thinner.

Ginseng

Can affect blood sugar and bleeding.

Turmeric and high-dose curcumin

Can affect the clotting system.

St John's wort

Can change the effect of anesthetic drugs.

Saying "I only take vitamins" or "I only take natural products" is therefore not enough. Every product you use should be named.

Do sports supplements matter?

Yes. The following should be assessed before surgery in particular:

• Creatine
• Fat-burning products
• Performance supplements
• Testosterone products
• Muscle-building supplements

The contents of some products can differ from what the label states, so it is important to report all supplements you take.

If you take corticosteroids, always say so

Long-term corticosteroid use can change the anesthesia plan. Patients taking drugs such as:

• Prednisolone
• Methylprednisolone
• Dexamethasone

regularly may need additional precautions. Corticosteroid use must therefore always be known.

Which drugs should I stop before surgery?

There is no universal answer, because the decision depends on:

• The planned operation
• The patient's age
• Accompanying conditions
• The type of drug involved

Rather than general advice read online, follow the recommendations given in your own anesthesia assessment.

What should I tell the anesthesiologist?

If possible, bring a list of all your medication to the consultation. Be sure to mention:

• Prescription drugs
• Diabetes medication
• Blood thinners
• Blood pressure medication
• Psychiatric medication
• Vitamins
• Herbal products
• Sports supplements
• Weight-loss drugs and injections

A detail that seems small can sometimes be an important part of the anesthesia plan.

The first step of safe anesthesia

The more the anesthesiologist knows about you, the safer and more personalised the plan can be.

Sharing your medication in full is therefore not a formality. It is one of the important parts of a safe operation.