Herbal Supplements to be Avoided Prior to Surgery

Herb

Relevant Effects

Surgery Concern

Recommendation

Echinacea

Boosts immunity. Allergic reactions, impairs immune suppressive drugs, could impair wound healing. Discontinue as far in advance as possible.

Ephedra

(ma huang)

Increases heart rate, increases blood pressure. Risk of heart attack, arrhythmia, stroke, interaction with other drugs, kidney stones. Discontinue at least 24 hours before surgery.

Garlic (ajo)

Prevents clotting. Risk of bleeding, especially when combined with other drugs that inhibit clotting. Discontinue at least 7 days before surgery.

Ginko

(duck foot, maidenhair, silver apricot)

Prevents clotting. Risk of bleeding, especially when combined with other drugs that inhibit clotting. Discontinue at least 36 hours before surgery.

Ginseng

Lowers blood glucose, inhibits clotting. Lowers blood-sugar levels.  Increases risk of bleeding.  Interferes with Warfarin (an anti-clotting drug). Discontinue at least 7 days before surgery.

Kava

(kawa, awa, intoxicating pepper)

Sedates,

Reduces anxiety.

May increase sedative effects of anesthesia.  Risks of addiction, tolerance and withdrawal unknown. Discontinue at least 24 hours before surgery.

St. John’s Wort

(Amber, Goatweed)

Inhibits re-uptake of neuro-transmitters (similar to Prozac). Alters metabolism of other drugs (such as Warfarin, steroids, protease inhibitors). Discontinue at least 5 days before surgery.

Valerian

Sedates Could increase effects of sedatives. Withdrawal symptoms resemble Valium addiction. If possible, taper dose weeks before surgery.