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An analog clock and a spilled bottle of ibuprofen: Understanding ibuprofen use before surgery
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Understanding ibuprofen use before surgery

Ibuprofen use should be discontinued at least one week prior to surgery
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By | Aug. 15, 2024 Medically reviewed by Anne Jacobson, MD, MPH

Key takeaways

  • Since NSAIDs like ibuprofen can inhibit platelet activity and increase the risk of bleeding during surgery, patients often need to discontinue using them at least a week in advance.

  • The specific timeline may depend on the patient and the type of surgery, and it’s typically okay to take ibuprofen before receiving local anesthesia from a dentist.

  • Tylenol doesn’t affect blood clotting like ibuprofen, so taking it before surgery is usually fine.

  • Tell the healthcare provider and anesthesiologist about every medication and supplement you take before surgery.

In this article:

Ibuprofen, a widely used over-the-counter (OTC) nonsteroidal anti-inflammatory drug (NSAID), effectively manages pain and inflammation. Whether it’s Advil, Motrin, or a generic version, ibuprofen is one of the most common pain medications in the United States. But despite its versatility, healthcare providers often advise patients to stop taking it before surgery.

Here, you’ll find all the critical details on why, how, and when to stop taking ibuprofen before a surgical procedure.

Can you take ibuprofen before surgery?

Medical professionals typically recommend discontinuing ibuprofen at least one week before surgery. “NSAIDs stay in your bloodstream for several days after taking them, which is why surgeons will tell you to stop taking them for varying amounts of time before a surgery,” says Dr. Jerry Friedman of North Jersey Oral & Maxillofacial Surgery. As Dr. Friedman implies, this timeframe can vary based on the patient or the type of surgery, but one week is typically the minimum. The same goes for Aleve or Naprosyn (naproxen), aspirin, Celebrex, and Voltaren-XR.

It’s typically fine to use ibuprofen or other analgesics before receiving a local anesthetic for a simple dental procedure. However, it’s best to ask the dentist or oral surgeon before taking them.

Should you take ibuprofen before surgery?

Before surgery, healthcare providers want to take every precaution they can to prevent excessive bleeding. Before procedures, they advise patients to stop taking antiplatelet drugs like Plavix and blood thinners like warfarin (Coumadin). Anti-inflammatory medications like ibuprofen can affect the functions of blood platelets, which slows the rate of blood clotting. Per Dr. Friedman, “Blood clotting is essential when it comes to healing wounds, and when you are having surgery, that becomes even more vital.” Healthcare providers need to stop any bleeding that occurs and inhibited clotting makes that a lot harder.

“In a surgical context, increased bleeding can complicate the procedure, prolong healing times, and elevate the risk of postoperative complications,” says Dr. Frank Stile, a board-certified plastic surgeon at the Las Vegas Gynecomastia Center. “Preoperative use of NSAIDs carries the risk of increased blood loss during surgery and higher transfusion rates.”

Ibuprofen usually only stays in a person’s system for around ten hours, but its effects on the blood can last much longer. That is why doctors recommend discontinuing it a week or more before surgical procedures.

Alternatives for pain relief before surgery 

Preoperative pain can be a concern, especially if it’s the reason for surgery. While ibuprofen is a common choice, it’s not the only option for preoperative pain relief. Several alternative pain relievers exist that won’t interfere with the surgical process.

The most common alternative for pre-surgery pain management is Tylenol (acetaminophen). “It provides effective pain relief without the anticoagulant effects,” Dr. Stile says. “Acetaminophen works centrally in the brain to reduce pain and fever, but does not significantly affect inflammation.” Unlike ibuprofen, it doesn’t inhibit platelet function, so it doesn’t pose the same risk of bleeding during surgery, and it’s safe to take any time up to the day of surgery.

Opioids like Percocet or Vicodin are also safe to use before surgery, but they come with their own set of risks and more serious side effects. Most importantly, opioids have a significant potential for addiction and abuse, and they’re classified as controlled substances by the DEA. Plus, opioid use disorder (OUD) can cause complications for anesthesiologists. So, it’s important to approach opioids carefully and be honest with the healthcare provider about how and when you’re taking them.

For people who have milder pain before an operation, non-medication pain relief options might work, too. These include physical therapy, aromatherapy, meditation, massage, or heat and cold. However, CBD and supplements like ginkgo, ginseng, garlic, kava, St. John’s wort, valerian, and vitamin E might affect anesthesia. So, the American Society of Anesthesiologists recommends telling the healthcare provider about every supplement you’re taking beforehand.

Other medications that may affect a patient’s response to general anesthesia include blood pressure drugs, weight loss medications l, diabetes medications, and blood thinners. Alcohol, cigarettes, and marijuana may also influence how anesthesia works, so be open about how often you use them.

The bottom line

​​It might be tempting to reach for the ibuprofen bottle whenever you’re in pain, but if you have surgery coming up, think twice. Since ibuprofen and other NSAIDs affect blood clotting, people typically have to discontinue them at least a week before surgery. Fortunately, there are some other options for pre-op pain control, primarily Tylenol, which don’t increase the risk of bleeding or impede the function of anesthesia.

No matter the type of surgery, it’s crucial to inform the healthcare provider and anesthesiologist about any medications and supplements you’re taking so they can assess your condition and provide alternatives if necessary.