Supplements to avoid during the peri-operative period
| Supplement | Use | Adverse Effects |
| Bilberry (Vaccinium Mrytillus) |
Visual acuity, antioxidant | Antiplatelet, inhibition of clot formation |
| Dong quai (Angelica sinensis) |
Relief of menopausal & menstrual disorders | May potentiate anticoagulant medications |
| Echinacea (Echinacea augustfolia) |
Immune system stimulant | Can cause hepatoxicity, contraindicated with hepatoxic drugs (anabolic steroids, methotrexate, etc.) |
| Ephedra (ma huang) |
Central nervous stimulant, appetite suppressant, antiasthmatic, nasal decongestant, bronchodilator | Hypertension, tachycardia cardiomyopathy, dysrhythmia myocardial infarction |
| Feverfew (Tanacetum parthenium) |
Migraine preventative, used for allergies | May affect clotting components, contraindicated with warfarin or other anticoagulants |
| Fish Oil Capsules | Contains Omega-3 derivatives DHA & EPA, used for hyper-cholesterolemia and elevated triglycerides | EPA & DHA inhibit platelet adhesion and aggregation. Excessive doses can inhibit wound healing |
| Garlic | Antispasmodic, antiseptic, antiviral, antihypertensive, used for hypercholesterolemia | Contraindicated with warfarin or other anticoagulants, NSAIDs, aspirin |
| Ginger (Zingiber officinale) |
Antinauseant, antispasmodic | Risk of prolonged clotting (Zingiber officinale) time. contraindicated with warfarin or other anti-coagulants, NSAIDs, aspirin |
| Ginkgo Biloba | Antioxidant, enhances cerebral blood flow, alleviates vertigo & tinnitus | Inhibition of platelet activity factor, contraindicated with warfarin or other anticoagulants, NSAIDs |
| Ginseng (Zingiber officinale)(Panax Ginseng; Panax quinquefolium) |
Improves physical & cognitive performance, antioxidant | May interact with cardiac & hypoglycemic agents, contraindicated with warfarin or other anticoagulants, NSAIDs |
| Goldenseal (Hydrastis canadensis) |
Mild laxative, reduces inflammation | May worsen swelling or high blood pressure |
| Hawthorne (Cratagaegus laevigata) |
Used for ischemic heart disease, hypertension, angina & chronic congestive heart disease | Potentiates actions of digitalis & other cardiac glycosides |
| Kava Kava (Piper Methysticum) |
Sedative, analgesic, muscle relaxant, anxiolytic | May potentiate CNS effects of barbiturates and general anesthesia |
| Licorice (Glycyrrhiza glabra) |
Used for gastric & duodenal ulcers, gastritis & bronchitis | May cause high blood pressure, hypokalemia and edema |
| Melatonin | Used for jet lag, insomnia and SAD (seasonal affective disorder) | May potentiate CNS effects of barbiturates and general anesthesia |
| Red Clover (Trifolium pretense) |
Used to relieve menopausal systems | May potentiate existing anticoagulant medications |
| St. John’s Wort (Hypericum perforatum) |
Antidepressant for mild to moderate depression | Contraindicated with other MAOIs or SSRIs, photosensitivity, multiple drug interactions |
| Valerian | Sleep aid, mild sedative | Contraindicated with sedatives or anxiolytics |
| Vitamin E | Antioxidant, used in treatment of cardiovascular disease | Anti-clotting benefits may prolong bleeding time |
| Yohimbe (Corynanthe yohimbe) |
Aphrodisiac, sexual stimulant | Hypertension, tachycardia, increases potency of anesthetic agents |
