Medication Reference Database
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Showing 536 of 536 medications Β· Hover any reference number for the full citation
abacavir | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
abacavir-lamivudine kivexa | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
abatacept orencia | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (q4 weeks typically). Resume β₯14 days post-surgery. | β Yes | |
abiraterone zytiga | Special β Hormone Therapy (Androgen Synthesis Inhibitor) | Continue perioperiatvely, including on the day of surgery | Take this medication on the day of surgery β do NOT abruptly stop the prednisone that is taken with abiraterone | Continue perioperatively per Morris Mayo Clin Proc 2026 Table 3 (Source #33; verbatim: "Do not hold"; half-life 14-16 hoβ¦ | β Yes | |
acalabrutinib calquence | Special β Oral Chemotherapy (BTK Inhibitors) | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD 3-7 DAYS pre- AND postoperatively depending on bleed risk, per Morris Mayo Clin Proc 2026 Table 4 (Source #33; verbβ¦ | β Yes | |
acamprosate campral | Pain/Addiction β GABA Agonist / Glutamate Antagonist | Continue perioperatively (hold if GFR <30) | Take this medication on the day of surgery | Continue perioperatively. NMDA modulator for alcohol use disorder; no significant anesthetic interactions; renally elimiβ¦ | β | |
acarbose | Diabetes β Oral Antidiabetic Agents | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on day of surgery. Alpha-glucosidase inhibitor taken with meals; functionally held when fasting. Not specifically aβ¦ | β | |
acebutolol sectral | Cardiovascular β Beta Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
acetaminophen tylenol, paracetamol, panadol | Analgesics β OTC | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
acetazolamide diamox | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue | β | |
acyclovir | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
adalimumab humira | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at END of dosing cycle. Resume minimum 14 days after surgery (absent wound healiβ¦ | β Yes | |
albuterol short-acting, ventolin, proair, salbutamol | Pulmonary β Beta2 Agonists (Inhaled) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
alendronate | Special β Bisphosphonates | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Routinely held on day of surgery. Oral/maxillofacial surgeons concerned about osteonecrosis of the jaw may recommend altβ¦ | β | |
alfuzosin xatral | Genitourinary β Alpha-1 Antagonists (BPH) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
alirocumab praluent | Non-Statin Lipid Lowering Agents | Continue perioperatively, including on day of surgery | Take this medication per your usual dosing schedule (do not stop) | Continue perioperatively. PCSK9 inhibitor (monoclonal antibody, biweekly SC injection). No demonstrated perioperative coβ¦ | β | |
aliskiren and combination products | Cardiovascular β Direct Renin Inhibitors | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on day of surgery. | β | |
allopurinol | Miscellaneous β Antigout Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
almotriptan | Antimigraine Agents β Triptans | HOLD on the day of surgery, or HOLD for 1 day before surgery | Do NOT take this medication on the day of surgery | Do NOT take on the day of surgery, or HOLD 1 day prior to procedure; vasoconstrictive effects | β | |
alprazolam | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
amantadine | Neuromuscular β Dopamine Agonists / Anti-Parkinson Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
amiloride midamor | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (potassium-sparing diuretic) | β Yes | |
amiloride midamor | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (potassium-sparing diuretic) | β | |
amiodarone | Cardiovascular β Antiarrhythmics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
amitriptyline elavil | Psychotropic β TCAs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue, particularly at higher doses. Per package insert, discontinue prior to elective surgery when possiblβ¦ | β | |
amlodipine norvasc | Cardiovascular β Calcium Channel Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
amphetamine | Miscellaneous β Stimulants / Anti-ADHD Agents | HOLD on day of surgery | Do NOT take this medication on the day of surgery | HOLD on morning of surgery per Oprea SPAQI 2022 Table 6 (Source #50; verbatim: "Hold on DOS"). Rationale: chronic amphetβ¦ | β Yes | |
anakinra kineret | Immunosuppressants β Biologic Agents | HOLD for 2 days prior to surgery | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (daily dosing β hold 1 day before surgery). Resume β₯14 daβ¦ | β Yes | |
anastrozole | Endocrine β Aromatase Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
anifrolumab saphnelo | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Continue this medication as per your usual dosing schedule | Continue cycle uninterrupted; schedule elective procedure right before end of cycle (q4 weeks IV). Anti-interferon typeβ¦ | β Yes | |
apalutamide | Special β Hormone Therapy (Prostate Cancer) | Continue perioperatively, including on day of surgery | Continue this medication as per your usual dosing schedule | Continue perioperatively per Morris Mayo Clin Proc 2026 Table 3 (Source #33; verbatim: "Do not hold"). Anti-androgen witβ¦ | β Yes | |
apixaban eliquis | Anticoagulants | Per institutional anticoagulation guideline (typically 48β72h) | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional guidelines: 'Management of Anticoagulant Medications in the Periprocedural and Surgical Settings'β¦ | β Yes | |
apremilast otezla | Immunosuppressants β DMARDs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE through surgery per SPAQI consensus. Phosphodiesterase-4 inhibitor; short half-life (6β9 hours). No reported inβ¦ | β | |
aripiprazole abilify | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
artificial tears | Miscellaneous β OTC Eye Drops & Nasal Sprays | Continue perioperatively, including on day of surgery | Take this medication on the day of surgery | Continue unless otherwise directed by physician. | β | |
asenapine saphris | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
aspirin asa, acetylsalicylic acid | Antiplatelet β Aspirin | HOLD for 7 Days Before Surgery (-7) β with exceptions | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 7 days prior to non-cardiovascular surgery. EXCEPTIONS: (1) Patients with coronary stentsβmost should remain on lowβ¦ | β Yes | |
aspirin/dipyridamole er aggrenox | Antiplatelet β Aspirin/Dipyridamole ER | HOLD for 7β10 Days Before Surgery (-7 to -10) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 7β10 days before surgery. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
atazanavir reyataz | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
atenolol tenormin | Cardiovascular β Beta Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
atomoxetine strattera | Miscellaneous β Stimulants / Anti-ADHD Agents | HOLD on day of surgery | Do NOT take this medication on the day of surgery | HOLD on morning of surgery per Oprea SPAQI 2022 Table 6 (Source #50; verbatim: "Hold on DOS"). Selective norepinephrineβ¦ | β Yes | |
atorvastatin lipitor | Cardiovascular β HMG-CoA Reductase Inhibitors (Statins) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
auranofin ridaura | Immunosuppressants β DMARDs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE through surgery per SPAQI consensus. Used for rheumatoid arthritis. Can decrease white blood cell count; obtainβ¦ | β | |
axitinib inlyta | Special β Oral Chemotherapy (Antiangiogenic TKIs) | Per oncologist; otherwise, HOLD for 3 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯2 DAYS before elective surgery per Morris Mayo Clin Proc 2026; FDA label. VEGFR-TKI with SHORT half-life (~2.5-6.1β¦ | β Yes | |
azathioprine non-severe sle | Immunosuppressants β Non-transplant (Non-severe SLE) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | DISCONTINUE 1 week prior to surgery for non-severe SLE; CONTINUE if severe SLE | β Yes | |
azathioprine severe sle, non-severe sle | Immunosuppressants β Non-transplant (Severe SLE) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE in perioperative period for severe SLE. | β | |
azathioprine transplant, non-severe sle | Immunosuppressants β Transplant Patients | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE (transplant patients). | β | |
azilsartan edarbi | Cardiovascular β Angiotensin Receptor Blockers (ARB) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 recommends HOLD on theβ¦ | β | |
baclofen | Analgesics β Skeletal Muscle Relaxants | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Class also includes benzodiazepines (alprazolam, clonazepam, diazepam). | β | |
baricitinib olumiant | Immunosuppressants β Biologic Agents | HOLD for 3 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | STOP 3 days prior to surgery per SPAQI 2022 consensus (updated from prior 7-day guidance). JAK inhibitor; short half-lifβ¦ | β Yes | |
beclomethasone qvar | Pulmonary β Inhaled Corticosteroids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
belimumab benlysta | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Continue this medication as per your usual dosing schedule | For NON-SEVERE SLE: hold for an entire dosing cycle; schedule surgery at week 2 (SQ) or week 5 (IV). Resume β₯14 days posβ¦ | β Yes | |
benazepril | Cardiovascular β ACE Inhibitors (ACE-I) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 and the 2024 AHA/ACC Pβ¦ | β | |
benralizumab fasenra | Pulmonary β Asthma/Atopic Biologics | Continue on usual dosing schedule | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue on regular dosing schedule per Morris Mayo Clin Proc 2026 / Brusselle NEJM 2022. Anti-IL-5RΞ±; SC q4-8 weeks. Deβ¦ | β | |
benztropine cogentin | Neuromuscular β Anti-Parkinson Anticholinergics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
berberine herbal, mao | Vitamins & Supplements | HOLD for 7 Days Before Surgery (-7) | Do NOT take this supplement for 1 week prior to surgery | HOLD 7 days prior. ASA NOTE (Ref 9): ASA patient-education materials suggest that all herbal medications and dietary supβ¦ | β | |
berberine herbal, mao | Vitamins & Supplements β Herbal (MAOI properties) | HOLD for 7 Days Before Surgery (-7) | Do NOT take this supplement for 1 week prior to surgery | HOLD 7 days prior. Note: found in goldenseal; may have MAO-inhibitory properties. ASA NOTE (Ref 9): ASA patient-educatioβ¦ | β | |
betahistine serc | Miscellaneous β Vestibular Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
bevacizumab avastin | Special β Oral Chemotherapy (Antiangiogenic Monoclonal Antibody) | Per oncologist; otherwise, HOLD for 28 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯28 DAYS (4 weeks) before elective surgery per Morris Mayo Clin Proc 2026 Table 5 (Source #33; verbatim: "Withholdβ¦ | β Yes | |
bicalutamide | Special β Hormone Therapy (Prostate Cancer) | Continue perioperatively, including on day of surgery | Continue this medication as per your usual dosing schedule | Continue perioperatively per Morris Mayo Clin Proc 2026 Table 3 (Source #33; verbatim: "Do not hold"). Non-steroidal antβ¦ | β | |
bictegravir-emtricitabine-tenofovir alafenamide biktarvy | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
bisoprolol monocor | Cardiovascular β Beta Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
brexpiprazole rexulti | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
brivaracetam brivlera | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
brodalumab siliq | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (q2 weeks β week 3). Resume β₯14 days post-surgery per SPAβ¦ | β Yes | |
bromazepam lectopam | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
bromocriptine parlodel | Neuromuscular β Dopamine Agonists / Anti-Parkinson Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
budesonide | Endocrine β Glucocorticoids (Systemic) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
budesonide | Endocrine β Glucocorticoids (Inhaled) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
bumetanide | Cardiovascular β Diuretics | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on day of surgery. If used for heart failure, consider volume statusβoptimize preoperatively. | β | |
buprenorphine | Special β Opioid Agonist-Antagonists / Antagonists | Individualizedβdefer to team | Take this medication on the day of surgery | DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. Depending on dose and type of surgery,β¦ | β Yes | |
buprenorphine | Special β Opioid Agonist-Antagonists / Antagonists | Individualizedβdefer to team | Take this medication on the day of surgery | DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. Depending on dose and type of surgery,β¦ | β Yes | |
buprenorphine sublocade β monthly sq injection | Special β Opioid Agonist-Antagonists / Antagonists | Individualizedβdefer to team | Take this medication on the day of surgery | DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. Depending on dose and type of surgery,β¦ | β Yes | |
buprenorphine-naloxone | Special β Opioid Agonist-Antagonists / Antagonists | Individualizedβdefer to team | Take this medication on the day of surgery | DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. See Buprenorphine Guideline. | β Yes | |
bupropion wellbutrin, zyban | Psychotropic β SNRIs / Bupropion | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Consider risk vs. benefit of increased bleeding risk. Discontinuation requires tapering over β₯2 weekβ¦ | β | |
buspirone | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
cabergoline dostinex | Neuromuscular β Dopamine Agonists / Anti-Parkinson Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
cabotegravir-rilpivirine cabenuva | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
cabozantinib cabometyx | Special β Oral Chemotherapy (Antiangiogenic TKIs) | Per oncologist; otherwise, HOLD for 21 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯21 DAYS before elective surgery per Morris Mayo Clin Proc 2026. VEGFR/MET TKI; long half-life ~99h (~4 days). Resuβ¦ | β Yes | |
canagliflozin invokana | Diabetes β SGLT-2 Inhibitors | HOLD for 3 days prior to surgery | Take this medication UP TO the date of last dose before 12pm; do NOT take this medication after 12pm | HOLD 3 days prior to surgery (Froedtert). Per Goldenberg 2025 STOP DKA-2: hold β₯3 days for higher-risk procedures; lowerβ¦ | β Yes | |
canakinumab ilaris | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (q4β8 weeks β weeks 5β9). Resume β₯14 days post-surgery peβ¦ | β Yes | |
candesartan | Cardiovascular β Angiotensin Receptor Blockers (ARB) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 recommends HOLD on theβ¦ | β | |
cannabidiol cbd, cbd oil, cannabidiol (cbd) β over-the-counter / non-prescription products | Special β Cannabinoids (Non-Prescription CBD) | No specific timing β discuss with anesthesia; counsel on drug interactions | Do NOT consume cannabis for at least 2 hours before surgery; ideally avoid for at least 72 hours | Per Shah/ASRA 2023: CBD is generally well tolerated; chronic high doses (up to 1500 mg PO/day) do not produce psychoactiβ¦ | β Yes | |
cannabis cannabis smoked, smoked cannabis, cannabis inhaled, cannabis flower, vaporized, hashish | Special β Cannabinoids (Recreational, Smoked/Inhaled) | Hold for min 2 h before surgery (ASRA Grade C); 72 h preferred; postpone if intoxicated | Do NOT smoke cannabis for at least 2 hours before surgery; ideally avoid for at least 72 hours | Per Shah/ASRA 2023: Universal screening for cannabis use is recommended (Grade A) β ask about type, route, amount, frequβ¦ | β Yes | |
cannabis oral oral cannabis, cannabis edibles, cannabis edible, edibles, cannabis tincture, tinctures, oromucosal, sublingual | Special β Cannabinoids (Recreational, Oral/Edibles) | Insufficient data for specific timing (ASRA Grade I); 72 hβ10 days suggested | Do NOT consume cannabis for at least 2 hours before surgery; ideally avoid for at least 72 hours | Per Shah/ASRA 2023: Oral cannabis has SLOW, VARIABLE absorption (highly fat-dependent) and PROLONGED effects compared toβ¦ | β Yes | |
capecitabine xeloda | Special β Oral Chemotherapy | HOLD for 8 Days Before Surgery (-8) for non-cancer surgery; 4-8 weeks after neoadjuvant chemotherapy for cancer surgery (per oncologist) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | Consult with treating oncologist prior to making changes. Per Morris Mayo Clin Proc 2026 (Source #33; capecitabine is reβ¦ | β Yes | |
captopril capoten | Cardiovascular β ACE Inhibitors (ACE-I) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 and the 2024 AHA/ACC Pβ¦ | β | |
carbamazepine tegretol | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
carbidopa/levodopa | Neuromuscular β Dopamine Agonists / Anti-Parkinson Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
carvedilol coreg | Cardiovascular β Beta Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
celecoxib celebrex | NSAIDs / COX-2 Inhibitors | HOLD for 1 Days Before Surgery (-1); or per PK (~3 days) | Do NOT take this medication on the day of surgery | HOLD on day of surgery. PK-based: ~3 days (COX-2 selective). | β | |
certolizumab cimzia | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (q4 weeks typically). Resume β₯14 days post-surgery. | β Yes | |
cetirizine | Miscellaneous β Antihistamines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
chlordiazepoxide librium | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
chlorpheniramine | Miscellaneous β Antihistamines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
chlorpromazine largactil | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
chlorthalidone uridone | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (thiazide). | β | |
cholecalciferol vitamin d, ergocalciferol, d3, d2 | Vitamins & Supplements | HOLD for 7 Days Before Surgery (-7); may continue for deficiency | Do NOT take this supplement for 1 week prior to surgery | Routinely hold 7 days prior. MAY CONTINUE if taken for documented deficiencyβdiscuss with preoperative provider. ASA NOTβ¦ | β | |
cholestyramine | Non-Statin Lipid Lowering Agents | HOLD for 1 day before surgery | Do NOT take this medication on the day before surgery and day of surgery | Discontinue for 1 day prior to surgery; impaired Vitamin K absorption | β | |
choline magnesium trisalicylate | NSAIDs / Nonacetylated NSAIDs | Continue perioperatively, including on day of surgery | Take this medication on the day of surgery | Continue perioperatively. Nonacetylated salicylate; MINIMAL platelet inhibition β may NOT need to hold. Half-life ~9-17hβ¦ | β | |
ciclesonide alvesco | Pulmonary β Inhaled Corticosteroids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
cilazapril inhibace | Cardiovascular β ACE Inhibitors (ACE-I) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 and the 2024 AHA/ACC Pβ¦ | β | |
cilostazol pletal | Antiplatelet | HOLD for 5 Days Before Surgery (-5) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD at least 5 days before surgery. Note: claudication symptoms may recur but will resolve once cilostazol is restartedβ¦ | β Yes | |
cimetidine | Gastrointestinal β H2 Receptor Blockers | HOLD on day of surgery | Do NOT take this medication on the day of surgery. | Multiple interactions with anesthetic medications | β | |
citalopram celexa | Psychotropic β SSRIs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Consider risk vs. benefit of increased bleeding risk. Consider discontinuing antiplatelet OR SSRI ifβ¦ | β | |
clobazam frisium | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
clomipramine anafranil | Psychotropic β TCAs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue at higher doses. Taper 7β14 days if high arrhythmia risk. | β | |
clonazepam | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
clonidine catapres | Cardiovascular β Alpha2 Agonists | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Abrupt withdrawal risks rebound hypertension. | β | |
clopidogrel plavix | Antiplatelet | HOLD for 5 Days Before Surgery (-5) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD at least 5 days before surgery. EXCEPTION: may consider continuing in perioperative period for peripheral artery anβ¦ | β Yes | |
clozapine clozaril | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β Yes | |
codeine | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. | β Yes | |
colchicine | Miscellaneous β Antigout Agents | Continue (hold if renal concern) | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. HOLD colchicine if there is concern for change in renal function. | β | |
colestipol | Non-Statin Lipid Lowering Agents | HOLD for 1 day before surgery | Do NOT take this medication on the day before surgery and day of surgery | Discontinue for 1 day prior to surgery | β | |
cyclobenzaprine | Analgesics β Skeletal Muscle Relaxants | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
cyclophosphamide cytoxan | Immunosuppressants β DMARDs | HOLD for 28 Days Before Surgery (-28) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD for 4 weeks before elective surgery per SPAQI consensus. Risk of infection is significant (neutropenia peaks ~14 daβ¦ | β Yes | |
cyclosporine | Immunosuppressants β Transplant Patients | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE. Patients with organ transplants should remain on immunosuppressants unless directed otherwise by transplant phβ¦ | β | |
cyproterone androcur | Endocrine β Transgender Hormone Therapy (MTF) | Continue (with VTE prophylaxis) or 2-4 weeks before major surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (with VTE prophylaxis) OR hold 2-4 weeks before major surgery with prolonged immobilization, per Morris Mayo Clβ¦ | β Yes | |
dabigatran pradaxa | Anticoagulants | Per institutional anticoagulation guideline | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
dalteparin (fragmin) β prophylaxis dose <5000 units/day | Anticoagulants β LMWH | Per institutional anticoagulation guideline | Do NOT take any dose on the day of surgery | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
dalteparin (fragmin) β treatment dose >5000 units/day | Anticoagulants β LMWH | Per institutional anticoagulation guideline | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
dapagliflozin farxiga | Diabetes β SGLT-2 Inhibitors | HOLD for 3 days prior to surgery | Take this medication UP TO the date of last dose before 12pm; do NOT take this medication after 12pm | HOLD 3 days prior to surgery. See canagliflozin notes. See also: GLP-1 and SGLT-2i Planner tab of app for individualizedβ¦ | β Yes | |
darifenacin | Urinary β Antispasmodic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
darolutamide | Special β Hormone Therapy (Prostate Cancer) | Continue (or hold for 4-5 Days Before Surgery if neutropenic) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | Per Morris Mayo Clin Proc 2026 Table 3 (Source #33; verbatim): "Consider holding 4-5 days if patient has history of neutβ¦ | β Yes | |
darunavir prezista | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
darunavir-cobicistat prezcobix | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue perioperatively per Morris Mayo Clin Proc 2026 / Emerick A&A 2023. Antiretroviral therapy should NEVER be interβ¦ | β Yes | |
degarelix firmagon | Special β Hormone Therapy (LHRH Antagonist) | Continue on usual dosing schedule | Continue this medication as per your usual dosing schedule | Continue on regular dosing schedule per Morris Mayo Clin Proc 2026 Table 3 (Source #33; verbatim: "Do not hold"; LHRH anβ¦ | β | |
denosumab prolia | Endocrine β Osteoporosis (RANKL Inhibitor) | Continue on usual dosing schedule | Take this medication per your usual dosing schedule (do not stop) | Continue on schedule per SPAQI 2022. Given SC every 6 months; do NOT delay or discontinue β REBOUND VERTEBRAL FRACTURESβ¦ | β | |
desiccated thyroid | Endocrine β Thyroid Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
desipramine norpramin | Psychotropic β TCAs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Taper 7β14 days if high arrhythmia risk. | β | |
desloratadine aerius | Miscellaneous β Antihistamines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
desmopressin | Urinary β Antispasmodic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
desvenlafaxine | Psychotropic β SNRIs / Bupropion | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Consider risk vs. benefit of increased bleeding risk. Tapering β₯2 weeks if discontinuing. | β | |
dexamethasone | Endocrine β Glucocorticoids (Systemic) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
dexlansoprazole dexilant | Gastrointestinal β Proton Pump Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
dextroamphetamine | Miscellaneous β Stimulants / Anti-ADHD Agents | HOLD on day of surgery | Do NOT take this medication on the day of surgery | HOLD on day of surgery. | β | |
diacetylmorphine heroin | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PAIN SPECIALIST, ADDICTION MEDICINE, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE Cβ¦ | β Yes | |
diclofenac voltaren, cataflam | NSAIDs / COX-2 Inhibitors | HOLD for 2 Days Before Surgery (-2); or per PK (~3 days) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 1 day prior to surgery. PK-based: ~1 day. | β | |
diflunisal | NSAIDs / Nonacetylated NSAIDs | HOLD for 3-4 Days Before Surgery (-3 to -4) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | Continue OR consider HOLDING 3-4 DAYS for high-bleeding-risk surgery. Nonselective NSAID; half-life ~8-12h. Russell SPAQβ¦ | β | |
digoxin lanoxin | Cardiovascular β Antiarrhythmics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
diltiazem cardizem, tiazac | Cardiovascular β Calcium Channel Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
dimenhydrinate gravol | Miscellaneous β Antihistamines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
diphenhydramine | Miscellaneous β Antihistamines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
dipyridamole persantine | Antiplatelet | HOLD for 2 Days Before Surgery (-2) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD at least 2 days before surgery. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
divalproex epival | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
dofetilide | Cardiovascular β Antiarrhythmics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
dolutegravir | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
domperidone | Gastrointestinal β Dopamine Antagonist | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
donepezil | Neuromuscular β Anticholinesterase Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Used for Alzheimer's disease or myasthenia gravis. | β | |
doravirine pifeltro | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
doravirine-lamivudine-tenofovir disoproxil fumarate delstrigo | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
doxazosin | Cardiovascular β Alpha1 Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. EXCEPTION: Consider discontinuation prior to cataract surgery due to association with floppy iris syndrome. Diβ¦ | β | |
doxepin sinequan | Psychotropic β TCAs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Taper 7β14 days if high arrhythmia risk. | β | |
dronabinol marinol, dronabinol (marinol) β synthetic thc, fda-approved | Special β Cannabinoids (FDA-Approved Pharmaceutical) | Continue (FDA-approved indication; abrupt cessation discouraged) | Take this medication on the day of surgery | Per Shah/ASRA 2023: FDA-approved for chemotherapy-induced nausea/vomiting and HIV/AIDS-associated wasting. ABRUPT CESSATβ¦ | β Yes | |
dronedarone | Cardiovascular β Antiarrhythmics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
dulaglutide trulicity | Diabetes/Obesity β GLP-1 Receptor Agonists (Weekly, Prolonged Half-life) | Not routinely held for most; 15 days prior for higher-risk patients (STOP-GAP) | Do NOT take this medication after this date of last dose | Refer to GLP1 & SGLT2i planner tab; Per Froedtert (Appendix C): consider holding for GI resection. Per STOP-GAP/Goldenbeβ¦ | β Yes | |
duloxetine cymbalta | Psychotropic β SNRIs / Bupropion | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Consider risk vs. benefit of increased bleeding risk. Tapering β₯2 weeks if discontinuing. | β | |
dupilumab dupixent | Pulmonary β Asthma/Atopic Biologics | Continue on usual dosing schedule | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue on regular dosing schedule per Morris Mayo Clin Proc 2026 / Brusselle NEJM 2022. Anti-IL-4RΞ±; SC q2 weeks. No pβ¦ | β | |
dutasteride avodart | Genitourinary β 5-Alpha Reductase Inhibitors (BPH) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
echinacea purple coneflower | Vitamins & Supplements β Herbal (Immunomodulatory) | No specific timing per Ang-Lee; 7 Days Before Surgery (-7) per institutional | Do NOT take this supplement for 1 week prior to surgery | Per Ang-Lee 2001: Activates cell-mediated immunity. Short-term use -> immunostimulation; long-term use (>8 weeks) -> potβ¦ | β Yes | |
edoxaban lixiana, savaysa | Anticoagulants | Per institutional anticoagulation guideline | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
efavirenz | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
efavirenz-emtricitabine-tenofovir disoproxil fumarate atripla | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
eletriptan | Antimigraine Agents β Triptans | HOLD on the day of surgery, or HOLD for 1 day before surgery | Do NOT take this medication on the day of surgery | Do NOT take on the day of surgery, or HOLD 1 day prior to procedure; vasoconstrictive effects | β | |
elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide genvoya | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue perioperatively per Morris Mayo Clin Proc 2026 / Emerick A&A 2023. Same CYP3A4 INHIBITION concerns as Prezcobixβ¦ | β Yes | |
elvitegravir-cobicistat-emtricitabine-tenofovir disoproxil fumarate stribild | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue perioperatively per Morris Mayo Clin Proc 2026 / Emerick A&A 2023. Same CYP3A4 INHIBITION concerns as Prezcobixβ¦ | β Yes | |
empagliflozin jardiance | Diabetes β SGLT-2 Inhibitors | HOLD for 3 days prior to surgery | Take this medication UP TO the date of last dose before 12pm; do NOT take this medication after 12pm | HOLD 3 days prior to surgery. See canagliflozin notes. See also: GLP-1 and SGLT-2i Planner tab of app for individualizedβ¦ | β Yes | |
emtricitabine | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
emtricitabine-tenofovir alafenamide descovy | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
emtricitabine-tenofovir disoproxil fumarate truvada | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
enalapril vasotec | Cardiovascular β ACE Inhibitors (ACE-I) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 and the 2024 AHA/ACC Pβ¦ | β | |
enfuvirtide fuzeon | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
enoxaparin lovenox, dalteparin, fragmin, tinzaparin, innohep, nadroparin, fraxiparine, lmwh, low molecular weight heparin, low-molecular-weight heparin | Anticoagulants | Per institutional anticoagulation guideline | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
entacapone | Neuromuscular β Dopamine Agonists / Anti-Parkinson Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
enzalutamide | Special β Hormone Therapy (Prostate Cancer) | Continue perioperatively, including on day of surgery | Continue this medication as per your usual dosing schedule | Continue perioperatively per Morris Mayo Clin Proc 2026 Table 3 (Source #33; verbatim: "Do not hold"). Anti-androgen witβ¦ | β Yes | |
ephedra ma huang | Vitamins & Supplements β Herbal (Sympathomimetic) | HOLD for >=24 Hours Before Surgery per Ang-Lee; 7 Days (-7) per institutional | Do NOT take this supplement for at least 24 hours prior to surgery | Per Ang-Lee 2001: Dose-dependent increase in HR/BP via direct (alpha-1, beta-1, beta-2) and indirect (norepinephrine relβ¦ | β Yes | |
epidiolex cannabidiol (epidiolex), cannabidiol (epidiolex) β pure cbd, fda-approved for epilepsy | Special β Cannabinoids (FDA-Approved Pharmaceutical) | Continue (antiepileptic; abrupt cessation discouraged) | Take this medication on the day of surgery | Per Shah/ASRA 2023: FDA-approved for Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis-associated seizureβ¦ | β Yes | |
eplerenone inspra | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (potassium-sparing diuretic) | β Yes | |
eplerenone inspra | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (potassium-sparing diuretic) | β | |
eprosartan teveten | Cardiovascular β Angiotensin Receptor Blockers (ARB) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 recommends HOLD on theβ¦ | β | |
eptifibatide integrilin | Antiplatelet | HOLD for 4-8 hours before surgery | Hold this medication for at least 4 to 8 hours preoperatively. | Hold this medication for at least 4 to 8 hours preoperatively. | β Yes | |
erenumab aimovig | Antimigraine Agents β CGRP Antagonists | Continue on usual dosing schedule | Take this medication per your usual dosing schedule (do not stop) | Continue perioperatively per SPAQI 2022. Monthly SC injection (CGRP antagonist). No bleeding, wound-healing, or anesthetβ¦ | β | |
ertugliflozin steglatro | Diabetes β SGLT-2 Inhibitors | HOLD for 4 days prior to surgery | Take this medication UP TO the date of last dose | HOLD 3 days prior to surgery. See canagliflozin notes. See also: GLP-1 and SGLT-2i Planner tab of app for individualizedβ¦ | β Yes | |
escitalopram lexapro, cipralex | Psychotropic β SSRIs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. See citalopram notes. | β | |
eslicarbazepine aptiom | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
esomeprazole nexium | Gastrointestinal β Proton Pump Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
estradiol-17Ξ² topical creams/patches divigel, estrogel, estradot, climara, oesclim | Endocrine β Transgender Hormone Therapy (MTF) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (preferred) with VTE prophylaxis per Morris Mayo Clin Proc 2026 / Skeith NEJM 2026 / Boskey JAMA Surg 2019. TRAβ¦ | β Yes | |
estrogen-progestin combination | Endocrine β Combined Oral Contraceptives (Estrogen-containing) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Consider risk of thromboembolism vs. benefits of pregnancy prevention. If discontinuing, consider stopping 4β6β¦ | β | |
estrogens | Special β Postmenopausal Hormone Therapy | Continue on day of surgery with appropriate VTE prophylaxis | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Per SPAQI Pfeifer 2020 (Ref 52): CONTINUE estrogens both before and on the day of surgery, but consider potential for inβ¦ | β Yes | |
eszopiclone lunesta | Psychotropic β Sedative-Hypnotics (Z-drugs) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
etanercept enbrel | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (typically weekly). Resume β₯14 days post-surgery | β Yes | |
ethacrynic acid edicrin | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (potassium-sparing diuretic) | β | |
ethopropazine parsitan | Neuromuscular β Anti-Parkinson Anticholinergics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
ethosuximide zarontin | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
etravirine intelence | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
evolocumab repatha | Non-Statin Lipid Lowering Agents | Continue perioperatively, including on day of surgery | Take this medication per your usual dosing schedule (do not stop) | Continue perioperatively. PCSK9 inhibitor (monoclonal antibody, biweekly SC injection). No demonstrated perioperative coβ¦ | β | |
exemestane | Endocrine β Aromatase Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
exenatide er bydureon | Diabetes/Obesity β GLP-1 Receptor Agonists (Weekly, Prolonged Half-life) | Not routinely held for most; ~6 weeks prior for higher-risk patients (STOP-GAP) | Do NOT take this medication after this date of last dose | Per STOP-GAP: most patients do not need hold; higher-riskβhold β₯3 half-lives (~6 weeks). Liquid diet day prior. | β Yes | |
exenatide ir byetta | Diabetes/Obesity β GLP-1 Receptor Agonists (Daily, Shorter Half-life) | HOLD on the day of surgery | Do NOT take this medication after this date of last dose | Refer to GLP1 & SGLT2i planner tab; HOLD on day of procedure (daily agent). Per STOP-GAP: ~5 half-lives β 1 day. Liquidβ¦ | β Yes | |
ezetimibe | Non-Statin Lipid Lowering Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue on day of surgery | β | |
famciclovir | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
famotidine pepcid | Gastrointestinal β H2 Receptor Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
febuxostat | Miscellaneous β Antigout Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
felodipine plendil | Cardiovascular β Calcium Channel Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
fenofibrate | Non-Statin Lipid Lowering Agents | HOLD for 1 Day Before Surgery | Do NOT take this medication on the day before surgery and day of surgery | Discontinue for 1 day prior to surgery | β | |
fentanyl | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. | β Yes | |
ferrous fumarate palafer | Iron Supplements | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Hold on the day of surgery. May interfere with GI assessment perioperatively. | β | |
ferrous gluconate fergon | Iron Supplements | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Hold on the day of surgery. May interfere with GI assessment perioperatively. | β | |
ferrous sulfate fer-in-sol, iron sulfate | Iron Supplements | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Hold on the day of surgery. May interfere with GI assessment perioperatively. | β | |
fesoterodine toviaz | Urinary β Antispasmodic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
fexofenadine | Miscellaneous β Antihistamines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
finasteride proscar | Genitourinary β 5-Alpha Reductase Inhibitors (BPH) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
flecainide | Cardiovascular β Antiarrhythmics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
fluoxetine prozac | Psychotropic β SSRIs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. See citalopram notes. Note long half-life. | β | |
flupenthixol fluanxol | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
fluphenazine moditen | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
flurazepam dalmane | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
flurbiprofen ansaid | NSAIDs / COX-2 Inhibitors | HOLD for 2 Days Before Surgery (-3) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 24-48 HOURS before surgery. Nonselective NSAID; half-life ~5.7-8h. Russell SPAQI 2022 Table 5 (Source #5) suggestsβ¦ | β | |
flutamide | Special β Hormone Therapy (Prostate Cancer) | 1-2 Days Before Surgery (-1 to -2) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | Per Morris Mayo Clin Proc 2026 Table 3 (Source #33; verbatim): "Consider holding 1-2 days prior to surgery." Non-steroidβ¦ | β Yes | |
fluticasone flonase, flovent | Endocrine β Glucocorticoids (Inhaled) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
fluvastatin lescol | Cardiovascular β HMG-CoA Reductase Inhibitors (Statins) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
fluvoxamine luvox | Psychotropic β SSRIs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. See citalopram notes. | β | |
fondaparinux (arixtra) β prophylaxis dose β€2.5 mg/day | Anticoagulants β Factor Xa Inhibitors | Per institutional anticoagulation guideline | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app; ASRA: Holβ¦ | β Yes | |
fondaparinux (arixtra) β treatment dose >2.5 mg/day | Anticoagulants β Factor Xa Inhibitors | Per institutional anticoagulation guideline | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app; ASRA: Holβ¦ | β Yes | |
formoterol long-acting | Pulmonary β Beta2 Agonists (Inhaled) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
formoterol-budesonide symbicort | Pulmonary β Combination Inhalers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
formoterol-mometasone zenhale | Pulmonary β Combination Inhalers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
fosamprenavir telzir | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
fosinopril monopril | Cardiovascular β ACE Inhibitors (ACE-I) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 and the 2024 AHA/ACC Pβ¦ | β | |
fosphenytoin cerebyx | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
fremanezumab ajovy | Antimigraine Agents β CGRP Antagonists | Continue on usual dosing schedule | Take this medication per your usual dosing schedule (do not stop) | Continue perioperatively per SPAQI 2022. Monthly SC injection (CGRP antagonist). No bleeding, wound-healing, or anesthetβ¦ | β | |
frovatriptan | Antimigraine Agents β Triptans | HOLD on the day of surgery, or HOLD for 1 day before surgery | Do NOT take this medication on the day of surgery | Do NOT take on the day of surgery, or HOLD 1 day prior to procedure; vasoconstrictive effects | β | |
furosemide lasix | Cardiovascular β Diuretics | Day of Surgery (0) - Exception: continue for heart failure with reduced ejection fraction | Do NOT take this medication on the day of surgery | HOLD on day of surgery. EXCEPTION: If used for heart failure, optimize volume status preoperatively; may consider continβ¦ | β | |
gabapentin neurontin | Analgesics β GABA Agonists | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. May be used to treat neuropathic pain. | β | |
galantamine | Neuromuscular β Anticholinesterase Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
galcanezumab emgality | Antimigraine Agents β CGRP Antagonists | Continue on usual dosing schedule | Take this medication per your usual dosing schedule (do not stop) | Continue perioperatively per SPAQI 2022. Monthly SC injection (CGRP antagonist). No bleeding, wound-healing, or anesthetβ¦ | β | |
garlic supplements | Vitamins & Supplements β Herbal (Hemostatic Effects) | HOLD for 7 Days Before Surgery (-7) | Do NOT take this supplement for 1 week prior to surgery | Per Ang-Lee 2001 + ASRA: sulfur-containing compounds (allicin, ajoene) inhibit platelet aggregation in dose-dependent faβ¦ | β | |
gemfibrozil | Non-Statin Lipid Lowering Agents | HOLD for 1 Day Before Surgery | Do NOT take this medication on the day before surgery and day of surgery | Discontinue for 1 day prior to surgery | β | |
ginkgo ginkgo biloba | Vitamins & Supplements β Herbal (Hemostatic Effects) | HOLD for >=36 Hours Before Surgery per Ang-Lee; 7 Days (-7) per institutional; ASRA no mandatory hold | Do NOT take this supplement for at least 36 hours prior to surgery | Per Ang-Lee 2001 + ASRA: terpenoids/flavonoids inhibit platelet-activating factor (PAF). Case reports of spontaneous intβ¦ | β | |
ginseng | Vitamins & Supplements | HOLD for 7 Days Before Surgery (-7) | Do NOT take this supplement for 1 week prior to surgery | Per Ang-Lee 2001 + ASRA: ginsenosides inhibit platelet aggregation (panaxynol effect may be IRREVERSIBLE in humans); proβ¦ | β | |
gliclazide diamicron | Diabetes β Oral Antidiabetic Agents | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on morning of surgery. Sulfonylurea β risk of hypoglycemia while NPO. Note: not specifically addressed in Sahai SPAβ¦ | β | |
glipizide glucotrol | Diabetes β Oral Antidiabetic Agents | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Per Duggan 2017 Table 2 and SAMBA consensus: Take usual dose the day BEFORE surgery, then HOLD on day of surgery in BOTHβ¦ | β | |
glyburide diabeta, glynase | Diabetes β Oral Antidiabetic Agents | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Per Duggan 2017 Table 2 and SAMBA consensus: Take usual dose the day BEFORE surgery, then HOLD on day of surgery in BOTHβ¦ | β | |
glycopyrrolate long-acting | Pulmonary β Anticholinergics (Inhaled) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
glycopyrronium-indacaterol-mometasone enerzair | Pulmonary β Triple Combination Inhalers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
golimumab simponi | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (typically 8 weeks). Resume β₯14 days post-surgery | β Yes | |
goserelin | Special β Hormone Therapy (LHRH Agonists) | Continue on usual dosing schedule | Continue this medication as per your usual dosing schedule | Continue on regular dosing schedule. SC implant q28 days or q12 weeks; no demonstrated perioperative concerns. Note: LHRβ¦ | β | |
guanfacine | Cardiovascular β Alpha2 Agonists | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
guselkumab tremfya | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (q12 weeks β week 13). Resume β₯14 days post-surgery per Sβ¦ | β Yes | |
haloperidol haldol | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
heme iron polypeptide proferrin | Iron Supplements | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Hold on the day of surgery. May interfere with GI assessment perioperatively. | β | |
heparin unfractionated heparin, ufh | Anticoagulants | Per institutional anticoagulation guideline | Do NOT take any dose on the day of surgery | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
humulin 70/30 novolin 70/30, novomix 30, novomix, novolog mix 70/30, premix 70/30, 70/30 premix | Diabetes β Insulin (Pre-Mixed) | 50% AM dose if BG β₯120 mg/dL; Hold if BG <120 mg/dL | Follow your doctor's dosing instructions. | Per Duggan 2017 Table 4: 50% of usual AM dose on day of surgery if BG β₯120 mg/dL (6.6 mM); HOLD on morning of surgery ifβ¦ | β Yes | |
hydralazine | Cardiovascular β Nitric Oxide / Vasodilators | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
hydrochlorothiazide hctz, microzide | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (thiazide). | β | |
hydrocodone | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. | β Yes | |
hydrocortisone | Endocrine β Glucocorticoids (Systemic) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
hydromorphone | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. | β Yes | |
hydroxychloroquine | Immunosuppressants β DMARDs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE through surgery. | β | |
ibandronate | Special β Bisphosphonates | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Routinely held on day of surgery. | β | |
ibrutinib imbruvica | Special β Oral Chemotherapy (BTK Inhibitors) | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD 3-7 DAYS pre- AND postoperatively depending on bleed risk, per Morris Mayo Clin Proc 2026 Table 4 (Source #33; verbβ¦ | β Yes | |
ibuprofen advil, motrin, brufen | NSAIDs / COX-2 Inhibitors | HOLD for 2 Days Before Surgery (-2); or per PK (1 day for ibuprofen) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD for 48 hours prior to surgery. | β | |
icosapent ethyl vascepa | Non-Statin Lipid Lowering Agents | HOLD for 8 Days Before Surgery (-8) for high-bleeding-risk surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | Consider HOLDING 7 DAYS before high-bleeding-risk surgery. Omega-3 fatty acid derivative β may increase bleeding time; Fβ¦ | β Yes | |
imatinib gleevec | Special β Oral Chemotherapy | Per oncologist; otherwise, HOLD on day of surgery | Do NOT take this medication on the day of surgery | Consult with treating oncologist prior to making changes | β Yes | |
imipramine tofranil | Psychotropic β TCAs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Taper 7β14 days if high arrhythmia risk. | β | |
indacaterol-mometasone atectura | Pulmonary β Combination Inhalers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
indapamide lozide | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (thiazide). | β | |
indomethacin indocin, indocid | NSAIDs / COX-2 Inhibitors | HOLD for 3 Days Before Surgery (-3); or per PK (~2 days) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 3 days prior. PK-based: ~2 days. | β | |
infliximab remicade | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (q8 weeks: receive week-0 dose, hold week-8 dose, schedulβ¦ | β Yes | |
insulin aspart novolog | Diabetes β Insulin (Short-Acting) | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on day of procedure (per Duggan 2017 Table 4: all rapid- and short-acting insulin held on day of surgery once fastiβ¦ | β Yes | |
insulin degludec tresiba | Diabetes β Insulin (Long-Acting) | 80% of usual basal dose (adjust 3 days in advance for Tresiba) | Follow your doctor's dosing instructions. | Per Duggan 2017 Table 4: 80% of usual dose on day of surgery if morning-only or twice-daily basal therapy. Tresiba has vβ¦ | β Yes | |
insulin detemir levemir | Diabetes β Insulin (Long-Acting) | 80% of usual basal dose | Follow your doctor's dosing instructions. | Per Duggan 2017 Table 4: 80% of usual dose on day of surgery if morning-only or twice-daily basal therapy. Day before suβ¦ | β Yes | |
insulin glargine lantus, basaglar, toujeo | Diabetes β Insulin (Long-Acting) | 80% of usual basal dose | Follow your doctor's dosing instructions. | Per Duggan 2017 Table 4: 80% of usual dose on day of surgery if patient uses morning-only or twice-daily basal therapy.β¦ | β Yes | |
insulin glargine toujeo | Diabetes β Insulin (Long-Acting) | 80% of usual basal dose (adjust 3 days in advance for Toujeo) | Follow your doctor's dosing instructions. | Per Duggan 2017 Table 4: 80% of usual dose on day of surgery if morning-only or twice-daily dosing. Toujeo (U-300) has pβ¦ | β Yes | |
insulin glulisine apidra | Diabetes β Insulin (Short-Acting) | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on day of procedure (per Duggan 2017 Table 4: all rapid- and short-acting insulin held on day of surgery once fastiβ¦ | β Yes | |
insulin lispro humalog | Diabetes β Insulin (Short-Acting) | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on day of procedure (per Duggan 2017 Table 4: all rapid- and short-acting insulin held on day of surgery once fastiβ¦ | β Yes | |
insulin pump | Diabetes β Insulin (Pump) | Continue basal rate; turn off if BG <110 mg/dL | Continue your insulin pump at usual basal rate; defer to Anesthesia on day of surgery | Per Duggan 2017: Patients with insulin pumps should CONTINUE insulin preoperatively and on the day of surgery. Intraoperβ¦ | β Yes | |
ipratropium short-acting | Pulmonary β Anticholinergics (Inhaled) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
ipratropium-albuterol combivent | Pulmonary β Combination Inhalers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
irbesartan | Cardiovascular β Angiotensin Receptor Blockers (ARB) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 recommends HOLD on theβ¦ | β | |
isocarboxazid | Psychotropic β MAOIs | Continue perioperatively or HOLD for 14 days (see instructions) | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | HIGH RISK: May need special instructions. Consider Anesthesia consultation. Generally continue ONLY if: (1) anesthesioloβ¦ | β Yes | |
isosorbide dinitrate | Cardiovascular β Nitric Oxide / Vasodilators | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
isosorbide mononitrate | Cardiovascular β Nitric Oxide / Vasodilators | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
ivabradine lancora | Cardiovascular β Sinoatrial Modulator | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
ixekizumab taltz | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (q4 weeks β week 5). Resume β₯14 days post-surgery per SPAβ¦ | β Yes | |
kava piper methysticum | Vitamins & Supplements β Herbal (Sedative / Anxiolytic) | HOLD for >=24 Hours Before Surgery per Ang-Lee; 7 Days (-7) per institutional | Do NOT take this supplement for at least 24 hours prior to surgery) | Per Ang-Lee 2001: Anxiolytic/sedative; kavalactones potentiate GABA inhibitory neurotransmission. Antiepileptic, neuroprβ¦ | β Yes | |
ketoprofen orudis | NSAIDs / COX-2 Inhibitors | HOLD for 1 day before surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 24 HOURS before surgery. Nonselective NSAID; short half-life ~2-4h. Russell SPAQI 2022 Table 5 (Source #5) suggestsβ¦ | β | |
ketorolac toradol | NSAIDs / COX-2 Inhibitors | HOLD for 3 Days Before Surgery (-3); or per PK (~2 days) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD for 48 hours prior to surgery. | β | |
labetalol | Cardiovascular β Beta Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
lacosamide vimpat | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
lamivudine | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
lamivudine-zidovudine combivir | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
lamotrigine lamictal | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
lansoprazole prevacid | Gastrointestinal β Proton Pump Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
leflunomide | Immunosuppressants β DMARDs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE through surgery. | β | |
lenvatinib lenvima | Special β Oral Chemotherapy (Antiangiogenic TKIs) | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯7 DAYS before major elective surgery per Morris Mayo Clin Proc 2026; FDA label warns of impaired wound healing. VEβ¦ | β Yes | |
letrozole | Endocrine β Aromatase Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
leuprolide | Special β Hormone Therapy (LHRH Agonists) | Continue on usual dosing schedule | Continue this medication as per your usual dosing schedule | Continue on regular dosing schedule. Depot injection (monthly / 3-monthly / 6-monthly); no demonstrated perioperative coβ¦ | β | |
levalbuterol short-acting | Pulmonary β Beta2 Agonists (Inhaled) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
levetiracetam | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
levodopa/benserazide prolopa | Neuromuscular β Dopamine Agonists / Anti-Parkinson Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
levodopa/carbidopa/entacapone stalevo | Neuromuscular β Dopamine Agonists / Anti-Parkinson Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
levomilnacipran fetzima | Psychotropic β SNRIs / Bupropion | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Consider risk vs. benefit of increased bleeding risk. Tapering β₯2 weeks if discontinuing. | β | |
levothyroxine synthroid, levoxyl, euthyrox | Endocrine β Thyroid Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
linagliptin tradjenta | Diabetes β Oral Antidiabetic Agents | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Per SPAQI 2020: hold on day of surgery, but may continue if undergoing ambulatory surgery where only 1 meal is missed. Pβ¦ | β | |
liothyronine cytomel | Endocrine β Thyroid Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
liraglutide victoza, saxenda | Diabetes/Obesity β GLP-1 Receptor Agonists (Daily, Shorter Half-life) | HOLD on the day of surgery | Do NOT take this medication after this date of last dose | Refer to GLP1 & SGLT2i planner tab; HOLD on day of procedure per Froedtert. Per Goldenberg 2025 (STOP-GAP): consider risβ¦ | β Yes | |
lisdexamfetamine vyvanse | Miscellaneous β Stimulants / Anti-ADHD Agents | HOLD on day of surgery | Do NOT take this medication on the day of surgery | HOLD on morning of surgery per Oprea SPAQI 2022 Table 6 (Source #50; lisdexamfetamine is a prodrug of dextroamphetamineβ¦ | β Yes | |
lisinopril zestril, prinivil | Cardiovascular β ACE Inhibitors (ACE-I) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 and the 2024 AHA/ACC Pβ¦ | β | |
lithium lithobid, eskalith | Psychotropic β Mood Stabilizers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
lixisenatide adlyxine | Diabetes/Obesity β GLP-1 Receptor Agonists (Daily, Shorter Half-life) | HOLD on the day of surgery | Do NOT take this medication after this date of last dose | Refer to GLP1 & SGLT2i planner tab; HOLD on day of procedure (daily agent). Per STOP-GAP: ~5 half-lives = 1 day. Liquidβ¦ | β Yes | |
lopinavir-ritonavir kaletra | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
loratadine | Miscellaneous β Antihistamines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
lorazepam | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
losartan cozaar | Cardiovascular β Angiotensin Receptor Blockers (ARB) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 recommends HOLD on theβ¦ | β | |
lovastatin mevacor | Cardiovascular β HMG-CoA Reductase Inhibitors (Statins) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
loxapine xylac, loxapac | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
lurasidone latuda | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
magnesium trisalicylate | NSAIDs / Nonacetylated NSAIDs | Continue perioperatively, including on day of surgery | Take this medication on the day of surgery | Continue perioperatively. Nonacetylated salicylate; MINIMAL platelet inhibition β may NOT need to hold even for surgery.β¦ | β | |
maraviroc celsentri | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
mefenamic acid ponstan | NSAIDs / COX-2 Inhibitors | HOLD for 1 day before surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 24 HOURS before surgery. Nonselective NSAID; very short half-life ~2h. Not specifically listed in Russell SPAQI 202β¦ | β | |
meloxicam mobic | NSAIDs / COX-2 Inhibitors | HOLD for 3 Days Before Surgery (-7); or per PK (~5 days) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 3 days prior to surgery. PK-based: ~5 days (long half-life). | β | |
memantine | Neuromuscular β Anticholinesterase Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
meperidine demerol | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. | β Yes | |
mepolizumab nucala | Pulmonary β Asthma/Atopic Biologics | Continue on usual dosing schedule | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue on regular dosing schedule per Morris Mayo Clin Proc 2026 / Brusselle NEJM 2022. Anti-IL-5; SC q4 weeks. No perβ¦ | β | |
mercaptopurine purinethol | Immunosuppressants β DMARDs | Continue or hold 1-2 days (per surgical team) | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (generally) OR hold 1-2 days per surgical team preference. Antimetabolite immunosuppressant β weigh infection rβ¦ | β Yes | |
mesalamine | Special β Aminosalicylates | Discuss with provider; otherwise, HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Routinely held on day of surgery. May continue if risk of flare > risk of bleeding. | β | |
metaxalone | Analgesics β Skeletal Muscle Relaxants | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
metformin glucophage | Diabetes β Oral Antidiabetic Agents | Typically HOLD on day of surgery; continue if minimally invasive; Hold for extensive surgery, IV contrast, or GFR <45 mL/min | Do NOT take this medication on the day of surgery | Per Duggan 2017 Table 2 / SAMBA consensus: Take day BEFORE surgery. HOLD if extensive surgery, anticipated hemodynamic cβ¦ | β | |
methadone metadol, methadose | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PAIN SPECIALIST, ADDICTION MEDICINE, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE Cβ¦ | β Yes | |
methazolamide neptazane | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue | β | |
methimazole | Endocrine β Thyroid Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
methocarbamol | Analgesics β Skeletal Muscle Relaxants | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
methotrexate | Immunosuppressants β DMARDs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE through surgery (per ACR 2017 guideline). | β | |
methotrimeprazine nozinan | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
methyldopa | Cardiovascular β Alpha2 Agonists | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
methylphenidate | Miscellaneous β Stimulants / Anti-ADHD Agents | HOLD on day of surgery | Do NOT take this medication on the day of surgery | HOLD on day of surgery. | β | |
methylprednisolone | Endocrine β Glucocorticoids (Systemic) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
metolazone zaroxolyn | Cardiovascular β Diuretics | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on morning of surgery per SPAQI 2022. Risk of intraoperative hypovolemia, hypotension, and electrolyte disturbancesβ¦ | β | |
metoprolol lopressor, toprol | Cardiovascular β Beta Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
minoxidil | Cardiovascular β Nitric Oxide / Vasodilators | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
mirabegron myrbetriq | Urinary β Antispasmodic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
mirtazapine remeron | Psychotropic β Serotonin Modulators / Other Antidepressants | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Taper 7β14 days if high arrhythmia risk. | β | |
moclobemide manerix | Psychotropic β Reversible MAO-I | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | either CONTINUE WITH CAUTION OR HOLD 24-48 HOURS is acceptable for moclobemide specifically (reversible MAO-A inhibitorβ¦ | β Yes | |
modafinil | Miscellaneous β Stimulants / Anti-ADHD Agents | HOLD on day of surgery | Do NOT take this medication on the day of surgery | HOLD on day of surgery. | β | |
mometasone asmanex | Pulmonary β Inhaled Corticosteroids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
montelukast singulair | Pulmonary β Leukotriene Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
morphine | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. | β Yes | |
multivitamin | Vitamins & Supplements | HOLD for 7 Days Before Surgery (-7) | Do NOT take this supplement for 1 week prior to surgery | DISCONTINUE all vitamins, supplements, and herbals 7 days prior to surgery. EXCEPTION: certain vitamins may be continuedβ¦ | β | |
mycophenolate mofetil non-severe sle | Immunosuppressants β Non-transplant (Non-severe SLE) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | DISCONTINUE 1 week prior to surgery for non-severe SLE; CONTINUE if severe SLE | β Yes | |
mycophenolate mofetil severe sle, non-severe sle | Immunosuppressants β Non-transplant (Severe SLE) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE in perioperative period for severe SLE. | β | |
mycophenolate mofetil transplant, non-severe sle | Immunosuppressants β Transplant Patients | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE (transplant patients). | β | |
nabilone cesamet, nabilone (cesamet) β synthetic cannabinoid, fda-approved | Special β Cannabinoids (FDA-Approved Pharmaceutical) | Continue (FDA-approved indication; abrupt cessation discouraged) | Take this medication on the day of surgery | Per Shah/ASRA 2023: FDA-approved synthetic cannabinoid mimicking THC; indicated for chemotherapy-induced nausea/vomitingβ¦ | β Yes | |
nabumetone relafen | NSAIDs / COX-2 Inhibitors | HOLD for 5 Days Before Surgery (-5); or per PK (~5 days) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 5 days prior. PK-based: ~5 days. | β | |
nadolol corgard | Cardiovascular β Beta Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
nadroparin (fraxiparine) β prophylaxis dose <2850 units/day | Anticoagulants β LMWH | Per institutional anticoagulation guideline | Do NOT take any dose on the day of surgery | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
nadroparin (fraxiparine) β treatment dose >2850 units/day | Anticoagulants β LMWH | Per institutional anticoagulation guideline | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
naltrexone injectable | Special β Opioid Agonist-Antagonists / Antagonists | HOLD 4 Days Before Surgery (-4) if opioid needed; otherwise defer to team | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. If opioid will be needed intraoperativeβ¦ | β Yes | |
naltrexone injectable | Special β Opioid Agonist-Antagonists / Antagonists | HOLD for 29 Days Before Surgery (-29) if opioid needed; defer to team | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. HOLD injectable naltrexone for 28 daysβ¦ | β Yes | |
naltrexone/bupropion contrave | Special β Opioid Agonist-Antagonists / Antagonists | HOLD for 4 Days Before Surgery (-4) for naltrexone component | Stop the naltrexone component β₯72 hours before surgery if opioid pain medication may be needed; bupropion can be continued | HOLD NALTREXONE component β₯72 HOURS before surgery if opioid analgesia anticipated, per Morris Mayo Clin Proc 2026. Naltβ¦ | β Yes | |
naproxen aleve, naprosyn | NSAIDs / COX-2 Inhibitors | HOLD for 3 Days Before Surgery (-3); or per PK (~4 days) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 3 days prior to surgery. PK-based: ~4 days. | β | |
naratriptan | Antimigraine Agents β Triptans | HOLD on the day of surgery, or HOLD for 1 day before surgery | Do NOT take this medication on the day of surgery | Do NOT take on the day of surgery, or HOLD 1 day prior to procedure; vasoconstrictive effects | β | |
nebivolol bystolic | Cardiovascular β Beta Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
neostigmine prostigmin | Neuromuscular β Anticholinesterase Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
nevirapine viramune | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
niacin | Non-Statin Lipid Lowering Agents | HOLD for 1 Day Before Surgery | Do NOT take this medication on the day before surgery and day of surgery | Discontinue for 1 day prior to surgery | β | |
nifedipine procardia, adalat | Cardiovascular β Calcium Channel Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
nilutamide | Special β Hormone Therapy (Prostate Cancer) | Continue perioperatively, including on day of surgery | Continue this medication as per your usual dosing schedule | Continue perioperatively per Morris Mayo Clin Proc 2026 Table 3 (Source #33; verbatim: "Do not hold"). Non-steroidal antβ¦ | β Yes | |
nitrazepam mogadon | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
nitroglycerin | Cardiovascular β Nitric Oxide / Vasodilators | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
nortriptyline pamelor | Psychotropic β TCAs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Taper 7β14 days if high arrhythmia risk. | β | |
novolog mix 70/30 | Diabetes β Insulin (Pre-Mixed) | 50% AM dose if BG β₯120 mg/dL; Hold if BG <120 mg/dL | Follow your doctor's dosing instructions. | Per Duggan 2017 Table 4: 50% of usual AM dose on day of surgery if BG β₯120 mg/dL (6.6 mM); HOLD on morning of surgery ifβ¦ | β Yes | |
novolog mix 75/25 humalog mix 75/25, humalog mix, novolog mix, premix 75/25, 75/25 premix | Diabetes β Insulin (Pre-Mixed) | 50% AM dose if BG β₯120 mg/dL; Hold if BG <120 mg/dL | Follow your doctor's dosing instructions. | Per Duggan 2017 Table 4: 50% of usual AM dose on day of surgery if BG β₯120 mg/dL (6.6 mM); HOLD on morning of surgery ifβ¦ | β Yes | |
nph insulin humulin n | Diabetes β Insulin (Intermediate) | 50% AM dose if BG β₯120 mg/dL; Hold if BG <120 mg/dL | Follow your doctor's dosing instructions. | Per Duggan 2017 Table 4: 50% of usual AM dose on day of surgery if BG β₯120 mg/dL (6.6 mM); HOLD on morning of surgery ifβ¦ | β Yes | |
olanzapine zyprexa | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
olmesartan olmetec | Cardiovascular β Angiotensin Receptor Blockers (ARB) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 recommends HOLD on theβ¦ | β | |
olsalazine dipentum | Special β Aminosalicylates | Discuss with provider; otherwise, HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Routinely held on day of surgery. May continue if risk of flare > risk of bleeding. | β | |
omalizumab xolair | Pulmonary β Asthma/Atopic Biologics | Continue on usual dosing schedule | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue on regular dosing schedule as per Morris Mayo Clin Proc 2026 / Brusselle NEJM 2022. Anti-IgE monoclonal antibodβ¦ | β | |
omeprazole prilosec | Gastrointestinal β Proton Pump Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
orlistat xenical | Diabetes β Oral Antidiabetic Agents | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on morning of surgery. Lipase inhibitor β GI side effects; no benefit perioperatively; may impair fat-soluble vitamβ¦ | β | |
oxaprozin daypro | NSAIDs / COX-2 Inhibitors | HOLD for 10 Days Before Surgery (-10); or per PK (~12 days) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 10 days prior. PK-based: ~12 days (very long half-life). | β | |
oxazepam serax | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
oxcarbazepine trileptal | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
oxybutynin | Urinary β Antispasmodic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
oxycodone | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. | β Yes | |
palbociclib ibrance | Special β Oral Chemotherapy (CDK 4/6 Inhibitors) | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯7 DAYS preoperatively per Morris Mayo Clin Proc 2026. CHECK ANC BEFORE SURGERY. Highest neutropenia risk among CDKβ¦ | β Yes | |
paliperidone invega | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
pantoprazole protonix | Gastrointestinal β Proton Pump Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
paroxetine paxil | Psychotropic β SSRIs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. See citalopram notes. | β | |
pazopanib votrient | Special β Oral Chemotherapy (Antiangiogenic TKIs) | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯7 DAYS before elective surgery per Morris Mayo Clin Proc 2026; Kayton J Surg Oncol 2023). VEGFR-TKI; half-life ~31β¦ | β Yes | |
perampanel fycompa | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
perindopril coversyl | Cardiovascular β ACE Inhibitors (ACE-I) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 and the 2024 AHA/ACC Pβ¦ | β | |
phenelzine | Psychotropic β MAOIs | Continue perioperatively or HOLD for 14 days (see instructions) | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | HIGH RISK: May need special instructions. Consider Anesthesia consultation. Generally continue ONLY if: (1) anesthesioloβ¦ | β Yes | |
phenobarbital | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
phentermine adipex-p | Miscellaneous β Weight Loss / CNS Stimulants | HOLD for β₯4 Days Before Surgery (-4) | Take this medication UP TO the date of last does (Do NOT take this medication for at least 4 days prior to surgery) | Per SPAQI Pfeifer 2021 GI/Pulmonary (Ref 53): WITHHOLD phentermine for at least 4 days before surgery. Sympathomimetic aβ¦ | β Yes | |
phentermine/topiramate qsymia | Miscellaneous β Weight Loss / CNS Stimulants | HOLD for β₯4 Days Before Surgery (-4) β wean or substitute topiramate to avoid seizures | Do NOT take this medication for at least 4 days prior to surgery (or wean over a week per manufacturer guidance to mitigate topiramate withdrawal seizure risk) | Per SPAQI Pfeifer 2021 GI/Pulmonary (Ref 53): WITHHOLD phentermine/topiramate for at least 4 days before surgery. Eitherβ¦ | β Yes | |
phenytoin dilantin | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
pioglitazone actos | Diabetes β Oral Antidiabetic Agents | Typically HOLD on day of surgery; continue if minimally invasive; Hold for extensive surgery, IV contrast, or GFR <45 mL/min | Do NOT take this medication on the day of surgery | Per Duggan 2017 Table 2: Take day BEFORE surgery. HOLD if extensive surgery, anticipated hemodynamic changes, or fluid sβ¦ | β | |
piroxicam feldene | NSAIDs / COX-2 Inhibitors | HOLD for 14 Days Before Surgery (-14); or per PK (~11 days) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 14 days prior. PK-based: ~11 days (very long half-life). | β | |
polysaccharide iron complex feramax, triferexx, polyride fe | Iron Supplements | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Hold on the day of surgery. May interfere with GI assessment perioperatively. | β | |
ponatinib iclusig | Special β Oral Chemotherapy (Antiangiogenic TKIs) | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯7 DAYS before elective surgery per Morris Mayo Clin Proc 2026. VEGFR/BCR-ABL TKI; half-life ~24h. Wound healing imβ¦ | β Yes | |
pramipexole mirapex | Neuromuscular β Dopamine Agonists / Anti-Parkinson Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
prasugrel effient | Antiplatelet | HOLD for 7 Days Before Surgery (-7) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD at least 7 days before surgery. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
pravastatin pravachol | Cardiovascular β HMG-CoA Reductase Inhibitors (Statins) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
prazosin | Cardiovascular β Alpha1 Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. EXCEPTION: Consider discontinuation prior to cataract surgery due to association with floppy iris syndrome. | β | |
prednisolone | Endocrine β Glucocorticoids (Systemic) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
prednisone | Endocrine β Glucocorticoids (Systemic) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
pregabalin lyrica | Analgesics β GABA Agonists | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. May be used to treat neuropathic pain. | β | |
primidone mysoline | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
probenecid | Miscellaneous β Antigout Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
procyclidine kemadrin | Neuromuscular β Anti-Parkinson Anticholinergics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
propafenone rythmol | Cardiovascular β Antiarrhythmics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
propranolol inderal | Cardiovascular β Beta Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
propylthiouracil ptu | Endocrine β Thyroid Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
pseudoephedrine | Miscellaneous β Cough/Cold Preparations | HOLD for 1 Day Before Surgery | Do NOT take this medication after 7am the day before surgery. | Hold for 24 hours prior to surgery. May interferece with anesthetic medications. | β | |
pyridostigmine | Neuromuscular β Anticholinesterase Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
quetiapine seroquel | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
quinapril accupril | Cardiovascular β ACE Inhibitors (ACE-I) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 and the 2024 AHA/ACC Pβ¦ | β | |
rabeprazole | Gastrointestinal β Proton Pump Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
raloxifene | Special β Selective Estrogen Receptor Modulators (SERMs) | Continue (if for breast cancer); hold β₯7 days only if other indication + VTE risk factors | Take this medication on the day of surgery (continue if for breast cancer prevention/treatment) | Per SPAQI Pfeifer 2020 (Ref 52): CONTINUE raloxifene both before and on the day of surgery if taken for breast cancer prβ¦ | β Yes | |
raltegravir isentress, isentress hd | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
ramipril altace | Cardiovascular β ACE Inhibitors (ACE-I) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 and the 2024 AHA/ACC Pβ¦ | β | |
ranitidine zantac | Gastrointestinal β H2 Receptor Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
ranolazine corzyna | Cardiovascular β Antianginal (Late Sodium Current Inhibitor) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
rasagiline | Psychotropic β MAOIs (Selective MAO-B) | Continue perioperatively; hold only for awake DBS placement | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Per SPAQI Oprea 2022 Neurologic (Ref 51): TAKE preoperatively, including on the day of surgery. Selective MAO-B inhibitoβ¦ | β Yes | |
regorafenib stivarga | Special β Oral Chemotherapy (Antiangiogenic TKIs) | Per oncologist; otherwise, HOLD for 14 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯7-14 DAYS before elective surgery per Morris Mayo Clin Proc 2026. VEGFR-TKI; half-life ~28h with ACTIVE METABOLITEβ¦ | β Yes | |
regular insulin humulin r | Diabetes β Insulin (Short-Acting) | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on day of procedure (per Duggan 2017 Table 4: all rapid- and short-acting insulin held on day of surgery once fastiβ¦ | β Yes | |
repaglinide | Diabetes β Oral Antidiabetic Agents | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Per Duggan 2017 Table 2 and SAMBA consensus: Take usual dose the day BEFORE surgery, then HOLD on day of surgery in BOTHβ¦ | β | |
reslizumab cinqair | Pulmonary β Asthma/Atopic Biologics | Continue on usual dosing schedule | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue on regular dosing schedule per Morris Mayo Clin Proc 2026 / Brusselle NEJM 2022. Anti-IL-5; IV q4 weeks. ANAPHYβ¦ | β | |
resveratrol | Vitamins & Supplements β Herbal (MAOI properties) | HOLD for 7 Days Before Surgery (-7) | Do NOT take this supplement for 1 week prior to surgery | HOLD 7 days prior. Note: may have MAO-inhibitory properties (see Appendix B). ASA NOTE (Ref 9): ASA patient-education maβ¦ | β | |
ribociclib kisqali | Special β Oral Chemotherapy (CDK 4/6 Inhibitors) | Per oncologist; otherwise, HOLD for 12 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD 7-12 days per Morris Mayo Clin Proc 2026; HOLD β₯2-5 DAYS preoperatively per Spring Oncologist 2017 (Source #40). CHβ¦ | β Yes | |
rilonacept arcalyst | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (weekly β week 2). Resume β₯14 days post-surgery per SPAQIβ¦ | β Yes | |
rilpivirine edurant | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
rilpivirine-emtricitabine-tenofovir disoproxil fumarate complera | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
ripretinib qinlock | Special β Oral Chemotherapy (Antiangiogenic TKIs) | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯7 DAYS before elective surgery per Morris Mayo Clin Proc 2026. KIT/PDGFRΞ± switch-control TKI; half-life ~14.8h. Reβ¦ | β Yes | |
risankizumab skyrizi | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (q12 weeks β week 13). Resume β₯14 days post-surgery per Sβ¦ | β Yes | |
risedronate | Special β Bisphosphonates | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Routinely held on day of surgery. | β | |
risperidone risperdal | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
ritonavir | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
rituximab rituxan | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (q6 months typically). Resume β₯14 days post-surgery. | β Yes | |
rivaroxaban xarelto | Anticoagulants | Per institutional anticoagulation guideline | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
rivastigmine | Neuromuscular β Anticholinesterase Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
rizatriptan | Antimigraine Agents β Triptans | HOLD on the day of surgery, or HOLD for 1 day before surgery | Do NOT take this medication on the day of surgery | Do NOT take on the day of surgery, or HOLD 1 day prior to procedure; vasoconstrictive effects | β | |
ropinirole requip | Neuromuscular β Dopamine Agonists / Anti-Parkinson Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
rosiglitazone avandia | Diabetes β Oral Antidiabetic Agents | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | HOLD on morning of surgery. Thiazolidinedione (TZD) β fluid retention may worsen perioperative edema. Can resume postopeβ¦ | β | |
rosuvastatin crestor | Cardiovascular β HMG-CoA Reductase Inhibitors (Statins) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
rotigotine neupro | Neuromuscular β Dopamine Agonists / Anti-Parkinson Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
saline nasal spray | Miscellaneous β OTC Eye Drops & Nasal Sprays | Continue perioperatively, including on day of surgery | Take this medication on the day of surgery | Continue unless otherwise directed by physician. | β | |
salmeterol long-acting | Pulmonary β Beta2 Agonists (Inhaled) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
salmeterol-fluticasone advair, arbesda | Pulmonary β Combination Inhalers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
salsalate | NSAIDs / Nonacetylated NSAIDs | Continue perioperatively, including on day of surgery | Take this medication on the day of surgery | Continue perioperatively. Nonacetylated salicylate; MINIMAL platelet inhibition β may NOT need to hold even for surgery.β¦ | β | |
sarilumab kevzara | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (q2 weeks β week 3). Resume β₯14 days post-surgery per SPAβ¦ | β Yes | |
saxagliptin onglyza | Diabetes β Oral Antidiabetic Agents | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Per SPAQI 2020: hold on day of surgery, but may continue if undergoing ambulatory surgery where only 1 meal is missed. Pβ¦ | β | |
scopolamine hyoscine | Gastrointestinal β Anticholinergic (Antiemetic) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
secukinumab cosentyx | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (typically q4 weeks). Resume β₯14 days post-surgery. | β Yes | |
selegiline | Psychotropic β MAOIs (Selective MAO-B) | Continue perioperatively; hold only for awake DBS placement | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Per SPAQI Oprea 2022 Neurologic (Ref 51): TAKE preoperatively, including on the day of surgery. Selective MAO-B inhibitoβ¦ | β Yes | |
selpercatinib retevmo | Special β Oral Chemotherapy (Antiangiogenic TKIs) | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯7 DAYS before elective surgery per Morris Mayo Clin Proc 2026; FDA label: withhold β₯7 days prior to elective surgeβ¦ | β Yes | |
semaglutide injectable ozempic, wegovy | Diabetes/Obesity β GLP-1 Receptor Agonists (Weekly, Prolonged Half-life) | Not routinely held for most; 21 days prior for higher-risk patients (STOP-GAP) | Do NOT take this medication after this date of last dose | Refer to GLP1 & SGLT2i planner tab; Per STOP-GAP: most patients do not need hold; higher-riskβhold β₯3 half-lives (~21 daβ¦ | β Yes | |
semaglutide oral rybelsus | Diabetes/Obesity β GLP-1 Receptor Agonists (Weekly, Prolonged Half-life) | Not routinely held for most; 21 days prior for higher-risk patients (STOP-GAP) | Do NOT take this medication after this date of last dose | Refer to GLP1 & SGLT2i planner tab; Per STOP-GAP: most patients do not need hold; higher-riskβhold β₯3 half-lives (~21 daβ¦ | β Yes | |
sertraline zoloft | Psychotropic β SSRIs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. See citalopram notes. | β | |
sildenafil viagra | Miscellaneous β Phosphodiesterase-5 Inhibitors | HOLD for 72 Hours Before Surgery, unless has pulmonary hypertension (continue) | Do NOT take this medication for 3 days prior to surgery (unless taking for pulmonary hypertension) | HOLD 72 hours prior to surgery. Recommendation only for patients with ED; for pulmonary hypertension, continue and deferβ¦ | β | |
silodosin rapaflo | Genitourinary β Alpha-1 Antagonists (BPH) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
simvastatin zocor | Cardiovascular β HMG-CoA Reductase Inhibitors (Statins) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
sirolimus rapamune | Immunosuppressants β Other (mTOR Inhibitor) | Talk to transplant team; otherwise, HOLD for 1-2 weeks prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 1-2 WEEKS before major surgery. mTOR inhibitor β IMPAIRS WOUND HEALING. Coordinate with transplant team given riskβ¦ | β Yes | |
sitagliptin januvia | Diabetes β Oral Antidiabetic Agents | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Per SPAQI 2020: hold on day of surgery, but may continue if undergoing ambulatory surgery where only 1 meal is missed. Pβ¦ | β | |
solifenacin | Urinary β Antispasmodic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
sorafenib nexavar | Special β Oral Chemotherapy (Antiangiogenic TKIs) | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯7 DAYS (β₯1 week) before elective surgery per Morris Mayo Clin Proc 2026 / Bose Lancet Oncol 2010. VEGFR-TKI β IMPAβ¦ | β Yes | |
sotalol | Cardiovascular β Antiarrhythmics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
spironolactone aldactone | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (potassium-sparing diuretic) | β Yes | |
st. john's wort | Vitamins & Supplements β Herbal (CYP450 Induction / Drug Interactions) | HOLD for >=5 Days Before Surgery per Ang-Lee; 7 Days (-7) per institutional | Do NOT take this supplement for at least 5 days prior to surgery | Per Ang-Lee 2001: PRIMARY MECHANISM is induction of CYP3A4 (~doubles metabolic activity) and CYP2C9 - MAOI activity is Iβ¦ | β Yes | |
sulfasalazine ra indication | Special β Aminosalicylates | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Avoid NSAIDs (increased risk of bleeding) | β | |
sulfasalazine ra indication | Immunosuppressants β DMARDs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE through surgery. | β | |
sulindac clinoril | NSAIDs / COX-2 Inhibitors | HOLD for 3-4 Days Before Surgery (-3 to -4) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 3-4 DAYS before surgery. Nonselective NSAID (prodrug); parent half-life ~7.8h; ACTIVE METABOLITE half-life ~16-18h.β¦ | β | |
sumatriptan | Antimigraine Agents β Triptans | HOLD on the day of surgery, or HOLD for 1 day before surgery | Do NOT take this medication on the day of surgery | Do NOT take on the day of surgery, or HOLD 1 day prior to procedure; vasoconstrictive effects | β | |
sunitinib sutent | Special β Oral Chemotherapy | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | Consult with treating oncologist prior to making changes | β Yes | |
tacrolimus | Immunosuppressants β Transplant Patients | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | CONTINUE. Patients with organ transplants should remain on immunosuppressants unless directed otherwise by transplant phβ¦ | β | |
tadalafil cialis | Miscellaneous β Phosphodiesterase-5 Inhibitors | HOLD for 72 Hours Before Surgery, unless has pulmonary hypertension (continue) | Do NOT take this medication for 3 days prior to surgery (unless taking for pulmonary hypertension) | HOLD 72 hours prior to surgery. For ED only; continue and defer to prescribing physician for pulmonary hypertension. | β | |
tafamidis | Cardiovascular β Transthyretin Stabilizers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue perioperatively. TTR stabilizer for ATTR cardiomyopathy. No demonstrated perioperative concerns. Very long halfβ¦ | β | |
tafamidis meglumine | Cardiovascular β Transthyretin Stabilizers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue perioperatively. TTR stabilizer for ATTR cardiomyopathy. No demonstrated perioperative concerns. Very long halfβ¦ | β | |
tamoxifen | Special β Selective Estrogen Receptor Modulators (SERMs) | Continue (if for breast cancer); hold β₯7 days only if other indication + VTE risk factors | Take this medication on the day of surgery (continue if for breast cancer prevention/treatment) | Per SPAQI Pfeifer 2020 (Ref 52): CONTINUE tamoxifen both before and on the day of surgery if taken for breast cancer preβ¦ | β Yes | |
tamsulosin | Cardiovascular β Alpha1 Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. EXCEPTION: Consider discontinuation prior to cataract surgery due to floppy iris syndrome. | β | |
tapentadol nucynta | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. | β Yes | |
telmisartan micardis | Cardiovascular β Angiotensin Receptor Blockers (ARB) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 recommends HOLD on theβ¦ | β | |
temazepam | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
tenofovir | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
terazosin | Cardiovascular β Alpha1 Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. EXCEPTION: Consider discontinuation prior to cataract surgery due to floppy iris syndrome. | β | |
terbutaline bricanyl | Pulmonary β Beta2 Agonists (Inhaled) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
teriparatide forteo, osnuvo | Endocrine β Osteoporosis (PTH Analogue) | Continue perioperatively, or HOLD on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue OR hold day of surgery per SPAQI 2022 β either is acceptable. Daily SC injection; no significant perioperativeβ¦ | β | |
testosterone androgel, testim, natesto, depo-testosterone, delatestryl | Endocrine β Transgender Hormone Therapy (FTM) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue perioperatively per Morris Mayo Clin Proc 2026 / Boskey JAMA Surg 2019. No increased VTE/MACE risk demonstratedβ¦ | β | |
theophylline | Pulmonary β Theophylline | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Hold on the day of surgery. | β | |
ticagrelor brilinta | Antiplatelet | HOLD for 3β5 Days Before Surgery (-3 to -5) | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | HOLD 5 days before surgery. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
tinzaparin (innohep) β prophylaxis dose | Anticoagulants β LMWH | Per institutional anticoagulation guideline | Do NOT take any dose on the day of surgery | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
tinzaparin (innohep) β treatment dose | Anticoagulants β LMWH | Per institutional anticoagulation guideline | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
tiotropium long-acting | Pulmonary β Anticholinergics (Inhaled) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
tipranavir aptivus | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
tirzepatide mounjaro, zepbound | Diabetes/Obesity β GLP-1 Receptor Agonists (Weekly, Prolonged Half-life) | Not routinely held for most; 15 days prior for higher-risk patients (STOP-GAP) | Do NOT take this medication after this date of last dose | Refer to GLP1 & SGLT2i planner tab; Per STOP-GAP: most patients do not need hold; higher-riskβhold β₯3 half-lives (~15 daβ¦ | β Yes | |
tizanidine | Analgesics β Skeletal Muscle Relaxants | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
tocilizumab actemra | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (typically q1-4 weeks). Resume β₯14 days post-surgery. | β Yes | |
tofacitinib xeljanz | Immunosuppressants β Biologic Agents | HOLD for 3 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | NOTE: SPAQI 2022 consensus recommends only 3 days hold for all JAK inhibitorsβdiscuss with prescribing rheumatologist. | β Yes | |
tolterodine | Urinary β Antispasmodic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
tramadol ultram | Analgesics β Opioids | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. DEFER TO ANESTHESIA, CHRONIC PROVIDER, SURGEON AND PREOPERATIVE CLINIC PROVIDER. | β Yes | |
trandolapril mavik | Cardiovascular β ACE Inhibitors (ACE-I) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 and the 2024 AHA/ACC Pβ¦ | β | |
tranylcypromine | Psychotropic β MAOIs | Continue perioperatively or HOLD for 14 days (see instructions) | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | HIGH RISK: May need special instructions. Consider Anesthesia consultation. Generally continue ONLY if: (1) anesthesioloβ¦ | β Yes | |
trazodone desyrel | Psychotropic β Serotonin Modulators / Other Antidepressants | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Taper 7β14 days if high arrhythmia risk. | β | |
triamterene | Cardiovascular β Diuretics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue (potassium-sparing diuretic) | β Yes | |
triazolam halcion | Psychotropic β Antianxiety / Benzodiazepines | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
trihexyphenidyl artane | Neuromuscular β Anti-Parkinson Anticholinergics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
triptorelin | Special β Hormone Therapy (LHRH Agonists) | Continue on usual dosing schedule | Continue this medication as per your usual dosing schedule | Continue on regular dosing schedule. IM depot; no demonstrated perioperative concerns. Note: LHRH/GnRH agonists are notβ¦ | β | |
umeclidinium-vilanterol-fluticasone trelegy | Pulmonary β Triple Combination Inhalers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
upadacitinib rinvoq | Immunosuppressants β Biologic Agents | HOLD for 3 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. | STOP 3 days prior to surgery per SPAQI 2022 consensus. JAK inhibitor; metabolized via CYP3A4/CYP3D6 β dose adjustments mβ¦ | β Yes | |
ustekinumab stelara | Immunosuppressants β Biologic Agents | See comments (end of dosing cycle) | Take the medication UP TO the date of last dose (Do NOT take this medication for one dosing cycle prior to surgery) | STOP prior to surgery; schedule surgery at end of dosing cycle (typically q8-12 weeks). Resume β₯14 days post-surgery. | β Yes | |
valacyclovir | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
valerian | Vitamins & Supplements β Herbal (Sedative / Anxiolytic) | Continue until day of surgery (taper over weeks if dependent) per Ang-Lee | If physically dependent, taper over several weeks before surgery; otherwise may continue until day of surgery | Per Ang-Lee 2001: Sedative/hypnotic via modulation of GABA neurotransmission and receptor function. Potentiates anesthetβ¦ | β Yes | |
valproate/valproic acid | Psychotropic β Mood Stabilizers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
valproic acid valproate, divalproex, depakote | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
valsartan diovan | Cardiovascular β Angiotensin Receptor Blockers (ARB) | HOLD on the Day of Surgery (0); also hold prior evening | Do NOT take your evening medication dose the night before surgery & do NOT take your medication on the day of surgery | HOLD on day of surgery. If dosed in evening, hold evening dose the night before. Sahai SPAQI 2022 recommends HOLD on theβ¦ | β | |
vandetanib caprelsa | Special β Oral Chemotherapy (Antiangiogenic TKIs) | Per oncologist; otherwise, HOLD for 28 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD β₯28 DAYS before elective surgery per Morris Mayo Clin Proc 2026. VEGFR/EGFR/RET TKI with VERY LONG half-life (~19 dβ¦ | β Yes | |
vardenafil levitra | Miscellaneous β Phosphodiesterase-5 Inhibitors | HOLD for 72 Hours Before Surgery, unless has pulmonary hypertension (continue) | Do NOT take this medication for 3 days prior to surgery (unless taking for pulmonary hypertension) | HOLD 72 hours prior to surgery (ED indication). | β | |
vedolizumab entyvio | Immunosuppressants β Biologic Agents | Continue on usual dosing schedule | Continue this medication as per your usual dosing schedule | Continue on schedule. Gut-selective integrin inhibitor (IV infusion q8 weeks). Limited systemic immunosuppression; no woβ¦ | β | |
venlafaxine effexor | Psychotropic β SNRIs / Bupropion | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. Consider risk vs. benefit of increased bleeding risk. Tapering β₯2 weeks if discontinuing. | β | |
verapamil calan, verelan | Cardiovascular β Calcium Channel Blockers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
vigabatrin sabril | Neuromuscular β Antiepileptic Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
vilanterol-fluticasone breo | Pulmonary β Combination Inhalers | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
vilazodone viibryd | Psychotropic β SSRIs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. See citalopram notes. | β | |
voclosporin lupkynis | Immunosuppressants β Non-transplant (Severe SLE) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue cycle uninterrupted for SEVERE SLE; schedule surgery at end of cycle. Calcineurin inhibitor for lupus nephritisβ¦ | β Yes | |
vortioxetine brintellix | Psychotropic β SSRIs | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Generally continue. See citalopram notes. | β | |
warfarin coumadin | Anticoagulants | Per institutional anticoagulation guideline (typically 5 days) | Take your last dose in the morning before 8am on the date of last dose. Do NOT take a dose in the evening. | Refer to institutional anticoagulation guideline. See also: Anticoagulant and Antiplatelet Therapy tab of app. | β Yes | |
zafirlukast | Pulmonary β Leukotriene Inhibitors | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | |
zanubrutinib brukinsa | Special β Oral Chemotherapy (BTK Inhibitors) | Per oncologist; otherwise, HOLD for 7 days prior to surgery | Take this medication on the date of last dose. Do NOT take this medication after this date of last dose. Consult oncologist. | HOLD 3-7 DAYS pre- AND postoperatively depending on bleed risk, per Morris Mayo Clin Proc 2026 Table 4 (Source #33; verbβ¦ | β Yes | |
zidovudine retrovir | Antiretroviral / Antiviral Agents | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β | β |
ziprasidone | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β | |
zoledronic acid | Special β Bisphosphonates | HOLD on the day of surgery | Do NOT take this medication on the day of surgery | Routinely held on day of surgery. | β | |
zolmitriptan | Antimigraine Agents β Triptans | HOLD on the day of surgery, or HOLD for 1 day before surgery | Do NOT take this medication on the day of surgery | Do NOT take on the day of surgery, or HOLD 1 day prior to procedure; vasoconstrictive effects | β | |
zolpidem sublinox | Psychotropic β Sedative-Hypnotics (Z-drugs) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
zopiclone imovane | Psychotropic β Sedative-Hypnotics (Z-drugs) | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. | β Yes | |
zuclopenthixol clopixol | Psychotropic β Antipsychotics | Continue perioperatively, including on day of surgery | Take this medication as you normally do, including on the day of surgery. If you take it in the morning, take your usual morning dose before coming in for surgery. If you take it at night, take your evening dose the night before surgery. | Continue. Use caution if combined with other QT-prolonging medications. Consider obtaining ECG if not done recently. | β |