Medical Oncologist
CION Cancer Clinics
Which medicines to stop before cancer surgery | CION Cancer Clinics
Only some medicines are paused before cancer surgery, mainly blood thinners, certain diabetes tablets and many herbal products. Most others, such as many blood pressure and thyroid tablets, are usually continued. Which ones you stop, and when, is decided by your surgeon, your anaesthetist and the doctor who prescribed them. Never stop a medicine on your own. This page explains what they look at and what to bring. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Do you have to stop all your medicines before surgery?
- Which kinds of medicine does the team ask about?
- What happens to your medicines between the clinic and the operation?
- What do the words on your medicine plan mean?
- What do families often get wrong about medicines before surgery?
- What should you tell the team, and why does it matter?
- What can this page not tell you?
- Common questions about stopping medicines before surgery
The short answer
Do you have to stop all your medicines before surgery?
No. Most people keep taking most of their medicines right up to the operation. A small group of medicines is paused, mainly those that thin the blood, some diabetes tablets and many herbal products, because they can change bleeding, blood sugar or how the anaesthetic behaves.
Who decides, and why it is never you alone
The decision is shared between your surgeon, your anaesthetist and the doctor who first prescribed the medicine. A heart or stroke doctor may need to agree first. Stopping the wrong tablet can cause a clot, a stroke or a dangerous rise in sugar. Stopping it too late can mean the operation is postponed on the day.
Why the timing is different for every person
How long before surgery a medicine is paused depends on the medicine, your kidney function, the size of the operation and the reason you take it. Two people on the same tablet can be given two different plans, and both can be right. That is why this page names no number of days.
Do not stop, start or change any medicine because of what you read here. Ask your team for a written plan.What the team looks at
Which kinds of medicine does the team ask about?
These are the groups that most often need a decision. Being on one of them does not mean it will be stopped.
Blood thinners
These lower the chance of a clot but raise the chance of bleeding during and after the operation. Some are paused, some are continued, and some are swapped for a short-acting injection.
Common names
- Aspirin (Ecosprin)
- Clopidogrel (Clopilet, Deplatt)
- Acitrom, warfarin, Eliquis, Xarelto
Diabetes medicines
You will not eat before surgery, so a tablet that lowers sugar can push it too low. Some newer tablets also carry a rare risk of acid building up in the blood around an operation.
Common names
- Metformin (Glycomet)
- Glimepiride (Amaryl)
- Jardiance, Forxiga, insulin
Blood pressure and heart tablets
Many are continued, including on the morning of surgery with a sip of water. A few types can drop the pressure under anaesthesia, so the anaesthetist may ask you to skip that morning's dose.
Herbal, Ayurvedic and supplements
Garlic pills, ginkgo, fish oil and several Ayurvedic mixtures can affect bleeding. The team cannot plan around what it does not know, so list every one of them, even the ones bought without a prescription.
Cancer medicines
Chemotherapy, targeted therapy and immunotherapy all affect healing and blood counts. Your medical oncologist and surgeon plan the gap between the last dose and the operation together.
Not sure whether this applies to you?
Ask an oncologistStep by step
What happens to your medicines between the clinic and the operation?
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The first surgical visit
Bring every strip, bottle and prescription in one bag. The packets show the exact brand, which a written list often gets wrong.
-
The pre-anaesthesia check
The anaesthetist goes through each medicine and your other health conditions. Blood tests may be ordered, such as a clotting test for anyone on Acitrom or warfarin.
-
Talking to the prescribing doctor
If you take a tablet for a stent, a heart valve, an irregular heartbeat or a past stroke, your surgical team may contact that doctor before deciding anything.
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A written plan
You should leave with a plan that names each medicine and says whether to continue, pause or change it, and from which date. If you are unsure about any line, ask before you go home.
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The morning of surgery
Take only what the plan says, with a small sip of water. Bring the medicine bag with you so the ward team can check it against your notes.
Words you may hear
What do the words on your medicine plan mean?
- Antiplatelet
- A medicine that stops tiny blood cells called platelets from clumping. Aspirin and clopidogrel are antiplatelets.
- Anticoagulant
- A medicine that slows the clotting process in the blood itself. Acitrom, warfarin, Eliquis and Xarelto are anticoagulants.
- INR
- A blood test that shows how thin the blood is for people on Acitrom or warfarin. The team checks it before the operation.
- Bridging
- Covering the gap with a short-acting injection while a longer-acting blood thinner is paused. Only some people need it.
- Nil by mouth
- No food, and only what you are told to drink, for a set time before the anaesthetic. It changes how some tablets should be taken.
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Commonly believed
What do families often get wrong about medicines before surgery?
"It is safer to stop everything well before the operation."
It is not. Stopping a blood pressure, heart or seizure medicine without a reason can make the operation riskier, not safer. Some tablets must be continued right up to the morning of surgery.
"Herbal and Ayurvedic products do not count as medicines."
They do. Several common ones change how the blood clots or how the anaesthetic works. Tell the team about every powder, oil, capsule and tonic, including the ones a relative brought from home.
"My uncle stopped his tablet early, so I will do the same."
Your uncle's plan was made for his operation, his kidneys and his reason for taking the tablet. Yours may be completely different. Follow only the plan written for you.
"If I forget to mention a medicine, the surgery will just go ahead."
If it comes to light on the morning, the operation may be postponed so the team can make it safe. Mentioning it early avoids a wasted trip and a second wait.
Before the visit
What should you tell the team, and why does it matter?
Tell them
Why they need to know
Any stent, valve, irregular heartbeat or past clot
It changes how safely a blood thinner can be paused
Your last sugar readings and any low-sugar episodes
It shapes the plan for the fasting morning
Every non-prescription product
Several affect bleeding or the anaesthetic
The date of your last chemotherapy or targeted dose
It affects healing and blood counts
Being straight with you
What can this page not tell you?
This page cannot tell you which of your own medicines to stop, or when. It does not know your operation, your kidney function, why you take each tablet or what your heart doctor has advised. Only the team treating you can put those together.
Who a general rule does not suit
General advice fits least well for people with a recent heart stent, a mechanical heart valve, a clot in the last few months, poorly controlled diabetes, kidney disease or several blood thinners at once. If any of these describes you or your parent, expect a more detailed plan .
If you are the son or daughter managing the tablets
You are often the one sorting the medicine box at home. Keep the written plan on your phone as a photo. Mark each pause and restart on a calendar. Ask the ward, before discharge, when each paused medicine should restart, because the answer is not always the same day.
Questions we are asked
Common questions about stopping medicines before surgery
How many days before surgery should I stop my blood thinner?
There is no single answer. It depends on which blood thinner you take, why you take it, how well your kidneys work and how large the operation is. Your surgeon and anaesthetist set the timing, often after speaking to your heart doctor. Follow only the date written on your own plan.
Can I take my blood pressure tablet on the morning of surgery?
Often yes, with a small sip of water, but not always. Some types of blood pressure tablet can make the pressure drop too far under anaesthesia, and the anaesthetist may ask you to skip that dose. Ask at the pre-anaesthesia check and write down the answer for each tablet by name.
What if I already stopped a medicine on my own?
Tell your surgical team today, and tell them the date you stopped. Do not restart it or stop anything else until you have spoken to them. If the medicine was a blood thinner for a stent, valve or past clot, also call the doctor who prescribed it, because the gap itself may carry a risk.
What if I took a tablet I was meant to skip?
Tell the ward nurse or anaesthetist as soon as you arrive, and say exactly what you took and when. Do not hide it for fear of being sent home. Sometimes the operation can still go ahead safely. Sometimes it has to be moved. Either way, the team needs to know before the anaesthetic starts.
Do I need to stop my thyroid tablet?
Thyroid tablets are usually continued, but confirm this for your own plan. Bring the strip so the team can see the exact medicine. If you are having an operation on the thyroid itself, the plan for thyroid medicines after surgery will be explained to you separately before you go home.
Should I stop my Ayurvedic or homeopathic medicines?
Tell the team about every one of them, by name, and bring the packets. Several herbal products affect bleeding or blood sugar, and some contain ingredients that are not listed clearly. The team will usually ask you to pause many of them before surgery. The exact timing is theirs to set.
Who do I ask if the surgeon and the heart doctor disagree?
Ask them to speak to each other directly rather than passing messages through you. That conversation is part of normal planning and most teams expect it. Until they agree and you have one written plan, keep taking the medicine as you were, and do not choose between the two versions yourself.
When will I restart the medicines that were stopped?
Each medicine has its own restart point, set by how the operation went and whether you are eating again. Ask for the restart plan in writing before discharge. If it is missing, call the ward rather than restarting on your own.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- NICE — Perioperative care in adults (NG180)
- Cancer Research UK — Surgery for cancer
- NHS — Anticoagulant medicines
- American Cancer Society — Cancer 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.
Keep reading
Related pages
Ecosprin and Aspirin Before Cancer SurgeryThe most common blood thinner, and when it is keptMetformin and Diabetes Tablets Around SurgeryWhat happens to sugar tablets on the fasting morningHerbal Medicines and Supplements Before SurgeryWhy Ayurvedic and herbal products need mentioningWhen Do You Restart Your Regular Medicines?The other half of the plan, after the operationThe Days Before Your OperationFasting, packing and paperwork
Talk to us
Not sure which of your tablets matter?
Tell us what surgery has been advised and bring your medicine list. We will help you reach the right surgical team to make a written plan.