What you need to know —
Herbal Supplements and Surgery

 

 

 

 

 

 

 

 

 

The American Society of Anesthesiologists advises patients to stop taking herbal supplements at least two to three weeks prior to surgery. If there is not enough time to stop herbal therapy before surgery, patients should bring the product (in its original container) to the hospital. This will allow the attending physician to see exactly what the patient is taking.

Table 1:

Herbal supplements that may increase risk of bleeding during or after surgery and may inhibit platelet function:
• Angelica root
• Clove
• Gamma Linolenic acid
• Onion
• Bilberry leaf
• Danshen
• Garlic
• Reishi mushroom
• Bromelian
• Dong guai
• Ginger
• Stinging nettle
• Capsicum (cayenne)
• Evening Primrose oil
• Gingko biloba
• Turmeric
• Celery
• Feverfew
• Grape seed oil
• Vitamin E (>400 lU/day)
• Chinese herbs
• Fish oil
• Horse chestnut

Contains coumarins:
• Alfalfa
• Capsicum (cayenne)
• Horse chestnut
• Quassia
• Angelica root
• Celery
• Licorice root
• Red clover
• Anise
• Chamomile
• Lovage root
• Rue
• Amica flower
• Dong guai
• Parsley
• Sweet clover
• Asafoetida
• Fenugreek
• Passionflower herb

Contains salicylates:
• Meadowsweet
• Poplar
• Willow bark

May interfere with anticoagulant therapy:
• Acerola
• Devil’s daw
• Garlic
• Papain
• Borage seed oil
• Dong guai
• Ginseng
• St. John’s Wort
• Chondroitin
• Coenzyme Q1O
• Goldenseal
• Vitamin E (>400 lU/day)
• Chorella
• Danshen
• Green tea

Other:
• Bogbean

Table 2:

Herbal supplements that may cause a reaction with anesthesia:
• Borage seed oil
• Ginger
• Kava kava
• St. John’s Wort
• Chamomile
• Gingko Biloba
• Ma Huang
• Valerian*
• Echinacea
• Ginseng
• Melatonin
• Ephedra
• Goldenseal
• Passionflower
• Evening Primrose oil
• Hawthorn
• Stinging nettle

Table 3:

Herbal supplements that may interfere with hemodynamic stability during surgery:
• Adonis
• Ephedra
• Guarana
• Quassia
• Aloe
• European mistletoe
• Hawthorn
• Reshi mushroom
• Anise
• Fenugreek
• L-arginine
• Stinging nettle
• Black cohosh
• Feverfew
• Licorice
• St. John’s Wort
• Buckthorn
• Fish oils
• Lobelia
• Strophanthus
• Capsicum (cayenne)
• Garlic
• Ma Huang
• Yohimbe
• Cat’s claw
• Ginger
• Motherwort
• Uzara root
• Devil’s claw
• Ginseng
• Oleander
• White squill
• Dogbane
• Goldenseal
• Pleurisy root

*Patients may need to taper off valerian over several weeks to avoid potential withdrawal symptoms