Medications

It is important to bring your medications when you come into hospital. In general, you should take all your regular medications on the morning of surgery with a small amount of water, but please take note of the following possible exceptions:

i. Diabetic medications: If you are a type 2 diabetic and are on oral tablets (e.g. metformin, gliclazide, glibenclamide etc) then you should not take your normal morning dose.

If you are a diabetic taking SGLT2 inhibitors, you need to aware that sometimes these will need to be stopped 3 days before surgery. SGLT2 inhibitors include dapagliflozin (Forxiga), empagliflozin (Jardiance), and ertugliflozin (Steglatro), as well as fixed dose combinations with metformin (Xigduo, Jardiamet, Segluromet) or with gliptins (Glyxambi,Qtern, Steglujan).

If you are on one of the above SGLT2 inhibitors, you should seek advice prior to surgery, even if the surgery is a colonoscopy.

If you are a type 1 diabetic or a type 2 diabetic requiring insulin injections, then please contact your anaesthetist before your surgery for specific instructions regarding the management of your diabetes.

ii. Anticoagulants – ‘blood thinners’: Anticoagulants (including aspirin) may or may not need to be ceased prior to surgery. Your surgeon usually provides instructions regarding the time required to stop these medications, prior to your surgery. If you take an anticoagulant, including warfarin, clopidogrel, ticagrelor, dabigatran or rivaroxaban and have not received instructions, please contact your surgeon prior to surgery.

iii. Herbal medications: If you are taking any natural or herbal medications, they should be stopped at least 5 days prior to elective surgery, as some of them can cause problems during your operation.