The first few weeks after gastric sleeve surgery is often called the “make or break” period. It is most crucial for the overall outcome of the surgery’s success but also the riskiest for complications. A majority of all complications occur within the first 30 days post-surgery.

If you have any specific questions regarding this list of medications to avoid after gastric sleeve surgery, please consult with your doctor.

Avoiding certain medications is one way to improve the outcome after gastric sleeve surgery. Please review the list of drugs and medications in this article to avoid. This list is NOT meant to be comprehensive. The surgeon liaison/physician will inform you of specific medications and drugs you should discontinue before and after gastric sleeve surgery.

1-Week After Bariatric Surgery

– Avoid All NSAIDs

NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) thin the blood and increase the risk of bleeding. Patients should not take NSAIDs for pain one week before and immediately after surgery.

If NSAIDs are taken within the week before surgery, the abnormality can show on pre-op labs and indicate to the surgeon it is not safe to continue with surgery. After recovery, the occasional use (less than 3x per month) of NSAIDs for pain is not restricted.

Note: Many anti-arthritic medications like Celebrex and Meloxicam are NSAIDs.

Daily use of NSAIDs post-operation is to be avoided. Chronic use of NSAIDs can also cause gastric ulcers. NSAIDs are an ulcer risk in all people. However, bariatric patients are at higher risk for developing gastric ulcers caused by long-term use due to smaller stomach size. The ratio of NSAID going into the stomach to the surface area of the stomach is higher. Aspirin for cardio health and chronic use of medications for arthritis is best to discontinue permanently. Bleeding ulcers can be fatal.

If you are prescribed or take NSAIDs daily for pain or stroke prevention,  speak to your primary care provider or cardiologist about non-NSAID treatment options. Physicians can prescribe Tylenol and non-NSAID pain relievers as an alternative to ibuprofen.

Related: What is Safe for Pain Management?

2-Weeks After Bariatric Surgery

– Discontinue Estrogen-Containing Medications

These medications are often prescribed for birth control or hormone replacement therapy (HRT).  Avoid hormone medications that contain Estrogen or Estrogen analogs. These medications are known to increase a person’s risk of a DVT (Deep Vein Thrombosis-blood clot in the leg).

In general, surgery increases a person’s danger of developing a DVT. Patients who have surgery and take these hormones are doubling their risk of developing a DVT. If a DVT dislodges from the leg, it can travel through the body and become lodged in the brain (STROKE) or lung (DEATH).

– Avoid All Steroids

These can lead to gastric ulcers, bleeding, or perforation. Oral steroids delay healing in the stomach and impair the stomach lining’s ability to form the protective layer between the muscle wall and acid. If steroid use is unavoidable, it should be accompanied by a proton pump inhibitor (PPI) like Prilosec or Prevacid. Some antacids that do not provide adequate protection include Pepcid and Zantac.

Occasional steroid use is acceptable. Chronic steroid use is to be avoided permanently. Steroid Injections and all steroids are to be discontinued for two weeks after surgery. After two weeks, steroid injections are acceptable.

One-Month After Bariatric Surgery

The risk will return to the same risk of taking the medication previously without the increased risk caused by post-op surgery status.

– Avoid All Nicotine Products

Nicotine increases a patient’s risk of developing a DVT after surgery. Avoid all nicotine products (gum, patches, cigarettes, etc.).

What about after two weeks? Toxins from smoking can adhere to saliva and mucous membranes, where they can travel to the stomach and promote gastric ulcer formation. Smoking is best to discontinue permanently. After two weeks, the risk of DVT from nicotine products returns to the same as before having a surgical procedure.

Medications to avoid after gastric sleeve surgery

Bariatric Surgery

– Gallstone and Gallbladder Removal

Rapid weight loss after bariatric surgery increases the risk of developing symptomatic gallstone disease. Studies show that approximately 25 to 30% of patients undergoing weight loss procedures may develop symptomatic gallstones within the first year postoperatively.

A regression analysis shows that gastric sleeve surgery has a higher chance of developing gallstones in some patients [2]. Gastric bypass may result in a chance of gallstone formation due to a slightly higher weight loss within the first 12 months.

Learn how to prevent gallstones after weight loss surgery

Some surgeons routinely remove the gallbladder for every patient undergoing weight loss surgery to prevent gallstone complications. Mexico Bariatric Center surgeons do not recommend the removal of the gallbladder at the time of the surgery unless the patient already has cholelithiasis. Our bariatric surgeons recommend administering ursodiol as prophylaxis therapy for 6 months after surgery.

– Bariatric Surgery Options

As bariatric surgeries alter the structure and function of the GI tract in various ways, it is crucial to evaluate patients’ comorbidities, other health issues, lifestyles, and levels of commitment when considering which surgery fits best for them. We hope that this overview proves helpful to you.

Written by the Surgeon Liaison at Mexico Bariatric Center®

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