Herbal Medicines and Orthopedic Surgery

The Full Story

Some herbal medicines and dietary supplements can affect blood clotting. This can complicate surgery and recovery if patients and doctors don't discuss ALL the medicines a patient is taking. Complications can include:

• prolonged bleeding of the surgical wound;
• bleeding into a joint or muscle, leading to pain and infection;
• the need for blood transfusions.

Orthopedic surgeons operate on bones and joints. Many of their patients have painful arthritis and use herbal medicines and other alternative therapies. They may also be taking prescribed medicines that could interact with herbal medicines.

Two orthopedic surgeons recently published their review of herbal medicines that could cause bleeding, interact with anesthesia, or cause other problems if patients don’t stop them before surgery. These herbals include echinacea, feverfew, garlic, ginger, ginkgo, ginseng, saw palmetto, St. John's wort, and valerian. Other supplements that should be stopped prior to surgery include glucosamine, chondroitin, Sam-e (S-adenosylmethionine), and bromelain.

Doctors should ask patients about all of their medicines, including prescription medicines, non-prescription medicines, herbal medicines, home remedies, and other alternative therapies. Likewise, patients should provide a complete list of all of their medicines, therapies, and remedies. Some medicines and supplements must be discontinued as long as one to two weeks before surgery. Likewise, it may be a week or more before it is safe to resume taking these preparations after surgery.

For questions about the safe use of your medicines or possible health effects, call Poison Control at 1-800-222-1222. Took too much of an herbal medicine or dietary supplement? Use the webPOISONCONTROL^® online tool, or call Poison Control. 

Rose Ann Gould Soloway, RN, BSN, MSEd, DABAT emerita
Clinical Toxicologist