Pre-Procedure Medication Instructions for Interventional Spine Safety

Introduction to Pre-Procedure Medication Management

At Desert Spine and Sports Physicians, our Arizona physiatrists prioritize your safety during interventional spine procedures. Managing your medications before surgery is crucial in ensuring the best possible outcomes. Many common medications, particularly those that affect blood clotting, may need to be adjusted or temporarily discontinued before your procedure.

It’s important to note that while some medications need to be stopped to reduce bleeding risks during surgery, discontinuing certain medications can also have risks. Therefore, we strongly recommend consulting your prescribing physician before changing your medication regimen.

General Medication Guidelines Before Spine Procedures

Some medications, especially those that affect blood clotting, need to be stopped before certain interventional spine procedures to reduce the risk of excessive bleeding during and after the procedure. However, it’s crucial to balance this with the potential risks of stopping these medications, particularly for patients with specific health conditions.

Our guidelines are general recommendations. Your specific situation may require different instructions, which is why communication with your healthcare providers is essential.

Specific Medication Guidelines

Anticoagulants and Antiplatelets

• Coumadin, Pradaxa, and Xarelto: Stop 5 days before your procedure. For patients on Coumadin, an INR will be drawn in the office on the morning of the procedure.
• Aspirin and products containing 325mg of Aspirin: Stop 7 days before your procedure. This includes medications like Bayer, Ecotrin, and Alka Seltzer. However, Aspirin 81mg is okay to continue.
• Plavix (clopidogrel bisulfate), Persantine (dipyridamole), and Aggrenox (ASA/dipyridamole): Stop 7 days before your procedure.
• Ticlid (ticlopidine HCL): Stop 14 days before your procedure.

*Note these medications do not need to be stopped for lumbar medial branch blocks, lumbar radiofrequency ablation, or sacroiliac joint injections.

Heparin Products

• Subcutaneous Heparin and Lovenox: Stop 12 hours before your procedure.
• Intravenous Heparin: Stop 4 hours before your procedure.

Medications to Continue

Our board-certified physiatrists recommend continuing all other prescribed medications, including pain medications not known to have bleeding effects. These include:

• Acetaminophen (Tylenol)
• NSAIDs, including Aleve, Advil, Ibuprofen, Diclofenac, Celebrex, Meloxicam, etc.
• Tramadol
• Hydrocodone and Oxycodone

For insulin-dependent diabetics, it’s generally recommended to take half your usual dose of insulin on the morning of the procedure. However, please contact your prescribing physician for exact instructions tailored to your specific needs.

FAQs About Pre-Procedure Medication Management

What should you do if you miss stopping a medication as instructed?

Contact our office immediately at (602) 840-0681. We’ll provide guidance based on your specific situation and the medication involved.

How should you handle over-the-counter medications?

Many over-the-counter medications, including supplements and herbal products, can affect bleeding risk. Always inform us of all medications you’re taking, including over-the-counter ones.

What are the steps if you are unsure about a medication?

If you have any doubts or questions about your medications, please don’t hesitate to contact our non-surgical specialists. It’s always better to ask than to risk complications.

Communicating with Your Healthcare Providers

Clear communication with all your healthcare providers is important for your safety. We recommend:

1. Keeping an up-to-date list of all your medications, including dosages and frequencies.
2. Sharing this list with all your healthcare providers.
3. Discussing any concerns or questions about medication changes with your prescribing physician.
4. Informing us of any changes to your medication regimen before your procedure.

Remember, these guidelines are in place to ensure your safety during and after your procedure. Following them closely can significantly reduce risks and contribute to a smoother recovery.

If you have any questions or concerns, please don’t hesitate to call us at (602) 840-0681. Our top priorities at Desert Spine and Sports Physicians are your safety and well-being.