Medical Oncologist
CION Cancer Clinics
Blood pressure tablets on the morning of your operation | CION Cancer Clinics
Many blood pressure tablets are taken as usual on the morning of surgery with a sip of water, while others, often the pril and sartan tablets and water tablets, may be paused. Your anaesthetist decides which is which at the pre-surgery check. This page explains the tablet families, what the team weighs, and what happens if your pressure is high on the day. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Should you take your BP tablet on the morning of surgery?
- Which family does your BP tablet belong to?
- What makes the team continue or pause a tablet?
- What should happen from the pre-surgery check to the operating room?
- What do these blood pressure terms mean?
- What if your blood pressure is high when you arrive?
- What do families believe about BP tablets and surgery?
- Common questions about BP tablets before surgery
The short answer
Should you take your BP tablet on the morning of surgery?
Many blood pressure tablets are taken as usual on the morning of surgery with a small sip of water, but some are paused. Which group your tablet falls into is decided by your anaesthetist at the pre-surgery check, and you should follow that instruction rather than a general rule.
Why some are continued
Stopping certain tablets suddenly can make your pressure or heart rate jump. That is the last thing anyone wants just before an anaesthetic. Tablets that steady the heart rhythm are a good example. Missing them can cause a fast heartbeat on the operating table.
Why some are paused
An anaesthetic lowers blood pressure on its own. Some tablets add to that drop, so the pressure can fall too far once you are asleep. Water tablets can also leave you dry and upset your salts after a long fast. For these, the team often asks you to leave out the morning dose.
What this page cannot tell you
It cannot tell you what to do with your own tablet. The same medicine can be continued for one person and paused for another, depending on your heart, your kidneys, what else you take and the size of the operation. It also gives no timings for stopping or restarting anything.
Never stop or skip a blood pressure tablet on your own before surgery. Ask first.Know your tablet
Which family does your BP tablet belong to?
The name on the strip tells the anaesthetist which group it is in. Many people in India take two or three of these in one combined tablet, so bring the strips themselves.
The "pril" and "sartan" tablets
Examples are ramipril, enalapril, telmisartan (Telma), losartan (Losar) and olmesartan. These are the tablets most often discussed before surgery, because they can deepen the drop in pressure under anaesthetic.
Often found in combinations like
- Telma-H, Telma-AM
- Losar-H
Beta blockers
Metoprolol (Met XL, Metolar), bisoprolol (Concor) and atenolol slow the heart. These are usually continued, because stopping them suddenly can make the heart race.
Calcium channel blockers
Amlodipine (Amlong, Stamlo) and cilnidipine relax the blood vessels. They are commonly continued, though your team may still adjust them if your pressure has been running low.
Water tablets
Hydrochlorothiazide, chlorthalidone, furosemide (Lasix) and torsemide make you pass more urine. They are often left out on the morning of surgery, both to avoid dehydration and because of the long wait without a toilet.
Not sure whether this applies to you?
Ask an oncologistWhat the team weighs
What makes the team continue or pause a tablet?
Points towards continuing
Points towards pausing
The tablet controls a fast or irregular heartbeat
Your pressure has been running low or you feel dizzy on standing
Your pressure is high and hard to control
A large operation with expected fluid shifts or blood loss
Missing a dose causes a rebound rise in pressure
Your kidney tests are borderline or your salts are off
It also treats heart failure or chest pain
You are on several pressure-lowering tablets together
Before and on the day
What should happen from the pre-surgery check to the operating room?
-
Pre-anaesthetic check
Bring every strip, including tablets from your heart doctor and your family doctor. The anaesthetist marks each one as continue or pause. Ask for that list in writing.
-
The night before
Take your evening tablets as the list says. Lay out the morning ones separately, so nobody in the family picks up the wrong strip at dawn.
-
The morning
Take only the tablets marked continue, with the small sip of water your fasting instructions allow. Put the paused strips in your bag.
-
Admission
Tell the nurse exactly which tablets you took and at what time. Your pressure is measured and recorded before you go in.
-
In the operating room
Your pressure is watched continuously. If it drops or rises, the anaesthetist has medicines to correct it within minutes.
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Words you will hear
What do these blood pressure terms mean?
- Hypertension
- The medical word for high blood pressure. It is on most admission forms.
- Hypotension
- Blood pressure that has dropped too low. This is what the team is trying to avoid under anaesthetic.
- ACE inhibitor or ARB
- The groups that the "pril" and "sartan" tablets belong to.
- Sip of water
- Just enough water to swallow tablets. It does not break your fasting instructions unless you were told otherwise.
- Rebound
- A sudden rise in pressure or heart rate after a tablet is stopped abruptly.
On the day
What if your blood pressure is high when you arrive?
A reading that is a little higher than usual on the morning of surgery is very common. Worry, a bad night and an empty stomach all push it up. The team will usually let you rest and measure it again before deciding anything.
When it may lead to a delay
If the pressure stays very high, or comes with chest pain, a severe headache or breathlessness, the anaesthetist may postpone a planned operation to bring it under control safely. For a cancer operation the team weighs that short delay against the need to proceed. This is their decision, made on the day with your readings in front of them.
Who needs more than the usual plan
People with heart failure, a recent heart attack or stent, kidney disease or pressure that is still uncontrolled on several tablets often need a heart doctor's opinion before surgery. If that is you, ask early rather than at admission.
Commonly believed
What do families believe about BP tablets and surgery?
"You are fasting, so you cannot take any tablet with water."
Fasting rules usually allow a small sip of water for the tablets you have been told to continue. Skipping a heart-rate tablet because of fasting can cause more trouble than the sip ever would.
"Stop all BP tablets a few days before, to be safe."
Stopping everything can send your pressure high and your heart rate fast just when the anaesthetic starts. Only the tablets the team names are paused, and only as they say.
"Take an extra tablet in the morning so the reading looks good."
An extra dose can make your pressure crash once you are asleep. Take exactly what is on your list, and let the team handle a high reading.
"The heart doctor's tablets are separate, so the surgeon need not know."
Every tablet you take affects the anaesthetic. Tell the team about all of them, including ones from other doctors.
Questions we are asked
Common questions about BP tablets before surgery
I take Telma-AM. Do I take it on the day?
Combination tablets contain two medicines, and the team may want to handle each part differently. Show the strip at your pre-anaesthetic check and ask. Sometimes the plan is to leave out the combination and take only one part, which may mean a different tablet for a short time.
I forgot and took all my usual tablets. What now?
Tell the admitting nurse straight away, with the names and the time you took them. It rarely means the operation is cancelled. The anaesthetist may watch your pressure more closely or adjust the plan. Hiding it is the only thing that makes it riskier.
How much water counts as a sip?
Just enough to swallow the tablets comfortably, not a full glass. Your anaesthetist gives the exact fasting rules for your operation, including the last time for clear fluids. If you are unsure, ask them to write it down for you.
When do I restart the tablets that were paused?
The team decides this after surgery, based on your pressure, your kidney tests, whether you are eating and drinking, and how much fluid you are receiving. Some are restarted quickly, others later. Ask for the restart plan in writing before you go home.
My pressure is well controlled. Does any of this matter?
Yes. Good control is exactly what the team wants to keep, and the right plan for your tablets is part of how they do that. Well-controlled pressure usually means fewer surprises on the day, but the tablets still need to be reviewed.
Will I get my BP medicines while I am in hospital?
Usually yes, once the team decides they are needed. If you cannot swallow for a while, pressure can be managed through a drip. Bring your strips so the ward knows exactly what you normally take, and tell the nurse if a dose seems to have been missed.
Can high blood pressure stop me having cancer surgery?
High pressure on its own rarely rules out an operation. It may lead to a short delay while it is controlled, or a review by a heart doctor. Whether and when to operate is decided by your surgeon and anaesthetist together, looking at your whole health.
Should my family bring my BP machine to the hospital?
It is not needed, because the ward checks your pressure regularly. A notebook with your recent home readings is useful though, especially at the pre-anaesthetic check. It shows your usual range, so a single high reading on the day can be read in context.
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Dr. C. Raghavendra Reddy
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Sources
- NICE — Perioperative care in adults (NG180)
- NHS — High blood pressure (hypertension)
- National Cancer Institute — Surgery to treat cancer
- Macmillan Cancer Support — Surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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