What should I ask about my medications before brain surgery or embolization?
What to ask about your medications before brain surgery or embolization: a complete list, written instructions, and coordination with your doctors.
By Dr. Martin Roberto Casas MartínezOct 23, 20266 min read
In this article
- Why are my medications so important before the procedure?
- What list should I prepare, and how?
- What specific questions should I ask about stopping or continuing my medications?
- How is coordination with the doctors who prescribed my medications handled?
- What else should I report: allergies, contrast dye, kidney problems, and pregnancy?
- Frequently asked questions
- What should I ask at the pre-procedure appointment?
- References
Summary: Before brain surgery or embolization, ask which medications to keep taking, which to temporarily stop and when, which to take on the day of the procedure, and who will coordinate those instructions with the doctors who prescribed them. Bring a complete list (prescription medications, over-the-counter medications, vitamins, herbs, and supplements), ask for written instructions, and do not make any changes on your own.
When brain surgery or embolization (treatment through the inside of an artery using a catheter) is scheduled, one of the patient’s most important tasks is reviewing their medications. Knowing what to ask about your medications before the procedure can help prevent last-minute changes and avoidable risks. This article organizes that review; your care team will give you specific instructions.
Why are my medications so important before the procedure?
Some medications affect blood clotting and may increase bleeding, others interact with anesthesia or contrast dye, and still others should not be interrupted because they control underlying conditions. Your care team needs the complete list to balance these risks.
Both open surgery and embolization involve working on blood vessels in the brain, where bleeding or a blood clot can have serious consequences. That is why medications that affect blood clotting receive special attention during the pre-procedure assessment.
Embolization also uses a contrast agent (a substance that makes arteries visible on X-rays), which is eliminated by the kidneys; certain medications and medical conditions affect how it is tolerated.
What list should I prepare, and how?
Prepare a written list of everything you take: prescription and over-the-counter medications, vitamins, herbs, and supplements. Write down each item’s name, amount, and schedule as they appear on the prescription, who prescribed it, and what it is for, and bring the list to every pre-procedure consultation.
- •Include anything you take “only sometimes”: pain relievers, anti-inflammatory medications, cold and flu medicines, and natural products.
- •Note any allergies and previous reactions to medications, anesthetics, or contrast dye.
- •If it’s easier, bring the packages or take photos of the labels.
- •Ask for the revised list to be added to your medical record and for a copy to be given to you.
What specific questions should I ask about stopping or continuing my medications?
Ask about each medication individually: should you continue it, temporarily stop it, or adjust it; on what date and until when; what to take on the morning of the procedure; and what to do if you miss a dose. Your care team—not you—makes that decision.
Your care team will often pay special attention to medications that affect blood clotting, such as anticoagulants, antiplatelet medications, and some anti-inflammatory medications. Being in this category does not mean you should stop taking them: in some cases, stopping them is riskier than continuing them, and only your care team can weigh those risks.
Ask for written instructions with dates, and check that they match what the anesthesiologist tells you. If you get different instructions from two doctors, don’t choose one yourself; ask them to agree on a plan.
How is coordination with the doctors who prescribed my medications handled?
Medications prescribed by other specialists (cardiologists, endocrinologists, neurologists, hematologists) are coordinated between that doctor and the team performing the procedure. Ask who will speak with whom, when, and how you will be given the final instructions.
A common example: someone taking antiplatelet medication for a heart condition needs their cardiologist to take part in the decision about whether to pause it. The same applies to medications for diabetes, epilepsy, or blood-clotting disorders.
Bring the name and contact information for each doctor who prescribes medication for you to your appointment, and let those doctors know that you have a procedure scheduled.
What else should I report: allergies, contrast dye, kidney problems, and pregnancy?
Tell your care team about allergies to anesthetics or contrast dye; kidney disease or diabetes, because contrast dye is eliminated through the kidneys; the possibility that you may be pregnant; tobacco and alcohol use; and any previous problems with anesthesia. All of this affects planning.
The pre-procedure assessment usually includes blood and urine tests and an electrocardiogram, and in some cases a chest X-ray or a consultation with another specialist. Those results also affect the instructions about your medications.
Frequently asked questions
What if I forgot to mention a supplement or herb?
Let your care team know as soon as you remember, even if the procedure is coming up soon. Some natural products and supplements affect blood clotting or interact with anesthesia, and your care team would rather know late than not at all.
Should I stop taking my blood pressure medications on the day of the procedure?
Don’t decide on your own. Ask your care team which medications to take on the morning of the procedure and which not to take; some should be taken with a small sip of water even while fasting. The instructions should be written down in your pre-procedure instructions.
How will I know which medications to take after the procedure?
Before you are discharged, ask for a written plan: what to resume, what new medication is being added, for how long, and whom to call if you have questions. Follow-up medications, such as those used with a stent, require specific instructions.
What should I ask at the pre-procedure appointment?
If you develop a sudden, severe headache, sudden weakness, or difficulty speaking while waiting for the procedure, call 911 first. Bring your complete list and consider asking:
- •For each medication on my list, which should I continue, which should I temporarily stop, and starting on what date?
- •Who will coordinate with my other doctors, and how will I receive the final instructions?
- •What should I take on the morning of the procedure, and whom should I call if I have a question before then?
To prepare your questions, you can find more information about allergies and kidney function before an angiogram and preparing for your first consultation.
For non-urgent questions or to request an individual assessment, you can contact the office.
Informational notice: This content is for informational purposes and does not replace a medical consultation or constitute a diagnosis.
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