Medical disclaimer: This is general information, not medical advice. It does not replace an exam or a conversation with a licensed clinician. Rules and registries change; confirm details with official sources before you decide.
Short answer: before surgery abroad, list everything you take, including vitamins, herbal products, teas and over-the-counter painkillers, and give that list to both your surgeon and your anesthesiologist in writing. They decide what to pause and when. Your home prescriber must be part of any decision about prescription drugs, especially blood thinners, which you should never stop on your own.
This is about the weeks before surgery. If you are looking for how to handle pain medicine and prescriptions after your operation, that's a separate topic covered elsewhere on this site.
Why the pre-op medication review matters
Medication reconciliation is the formal name for something simple: making sure your surgical team knows exactly what is in your body. At home, this often happens automatically because your records travel between doctors. Abroad, it doesn't. Your Colombian surgeon sees only what you tell them, and travelers routinely leave things out because they don't think of them as "medicine": a daily fish oil capsule, a turmeric supplement, a sleep tea, a few ibuprofen a week.
Those details matter for two main reasons:
- Bleeding. Some drugs and supplements affect how your blood clots. That can matter during surgery and afterward, for example in the form of bruising or a collection of blood under the skin.
- Anesthesia. Some products change how your body handles anesthetic and sedating drugs, affect blood pressure or heart rhythm, or interact with medicines you'll be given around surgery.
The American Society of Anesthesiologists has long encouraged patients to tell their anesthesiologist about all herbal and dietary supplements before surgery. That advice applies equally when your anesthesiologist is in Medellín or Bogotá.
Blood thinners, aspirin and anti-inflammatories
If you take a blood thinner or antiplatelet drug because of a heart stent, atrial fibrillation, a past clot, a mechanical valve or a stroke, stopping it without a plan can cause a serious clot. The decision about whether to pause it, for how long, and whether you need a substitute belongs to your prescriber working with your surgical team.
| Category | Examples you might recognize | Who needs to weigh in |
|---|---|---|
| Anticoagulants | Warfarin, apixaban, rivaroxaban, dabigatran | Your prescriber plus surgeon and anesthesiologist |
| Antiplatelet drugs | Clopidogrel, prasugrel, ticagrelor, prescribed aspirin | Your prescriber (often a cardiologist) plus surgical team |
| Over-the-counter NSAIDs | Ibuprofen, naproxen, aspirin taken for pain | Surgeon and anesthesiologist |
| Weight-loss and diabetes drugs | GLP-1 medicines, SGLT2 inhibitors, insulin | Your prescriber plus anesthesiologist |
| Hormones | Birth control, hormone therapy, testosterone | Your prescriber plus surgeon |
| Mood and sleep medicines | Antidepressants, anxiety and sleep medications | Your prescriber plus anesthesiologist |
Aspirin deserves a special note. Low-dose aspirin that a doctor prescribed for your heart is a very different situation from aspirin you take for a headache. Tell your team which one it is. The same goes for anti-inflammatory painkillers: they are easy to forget because they're sold everywhere, including in Colombian pharmacies without a prescription.
Some medicine categories in the table, like GLP-1 drugs, have their own detailed guidance. The point here is not to make decisions from a table but to make sure nothing is missing from the list you hand over.
Supplements and herbs to mention
Natural doesn't mean neutral. Several widely used supplements have been associated in medical literature and patient-education material with effects on bleeding or platelet function. The strength of that evidence varies, and for many products it is limited or mixed. That uncertainty is exactly why your team should know about them and decide.
- Fish oil / omega-3 capsules, including high-dose products
- Vitamin E, alone or in a multivitamin with a high dose
- Ginkgo biloba
- Garlic supplements (concentrated pills, not ordinary cooking)
- Turmeric / curcumin
- Ginseng and ginger supplements
- Any "blend" product where you aren't sure of every ingredient
Other supplements raise different questions. Products marketed for sleep, anxiety, energy or weight loss can contain ingredients that affect sedation, heart rate or blood pressure. Pre-workout and "fat burner" products are a common example. If a label lists many ingredients, take a photo of it for your anesthesiologist.
Photograph the front and the ingredients panel of every bottle you take. Labels show the dose and the exact ingredients, which is far more useful to a doctor than "a vitamin."
Don't assume you need to stop everything, either. Some supplements may be fine to continue, and some may matter for your recovery. A clear list lets your team give you specific instructions rather than a generic "stop all supplements" that may not suit you.
St. John's wort and other interactions
St. John's wort, an herbal product some people take for low mood, is well known for interacting with a wide range of medicines because of how it affects the liver's processing of drugs. It can change the levels of other medications in your body, and its use is also relevant if you take antidepressants. Tell both your surgeon and anesthesiologist about it, and don't stop or start it abruptly without asking.
Other things worth mentioning, even if they don't feel like "medications":
- Cannabis in any form, and how often you use it
- Alcohol, honestly described
- Nicotine in any form
- Recreational drugs, which affect anesthesia planning; your team needs facts, not judgment
- Any medicine you've started recently, including antibiotics or steroids
Who decides: surgeon, anesthesiologist or home prescriber
Pre-op medication decisions are shared. When a single instruction is missing or conflicting, you are the person who notices, so it helps to know who owns which piece.
The drugs they started
Whether a prescription medicine can safely be paused, what replaces it if needed, and when to restart. Ask them directly, with the surgery date.
Bleeding and healing
What the operation needs from you: which products affect bleeding risk for this procedure, and when they want them paused.
Anesthesia safety
Interactions with anesthetic and pain drugs, which medicines to take the morning of surgery, and fasting instructions.
The connector
Sharing the full list, passing instructions between doctors, and asking when two answers don't match.
- Send your list earlyEmail the full list to the Colombian surgeon and ask for it to reach the anesthesiologist, ideally several weeks before surgery.
- Ask for written instructionsRequest a written list of what to pause, what to continue and what to take on the morning of surgery, with dates.
- Check with your prescriberShow those instructions to the doctor who prescribes each medicine and ask whether it's safe for you.
- Resolve conflicts before you flyIf two doctors disagree, ask them to talk to each other, or ask the surgeon to confirm the final plan in writing.
- Confirm restart datesAsk when to restart each paused medicine after surgery, and whether that changes if there's bleeding or a complication.
How to build a bilingual medication list
A one-page list in English and Spanish is one of the most useful documents you can carry. Keep it on paper and on your phone, and give a copy to your travel companion.
| English | Spanish | What to write |
|---|---|---|
| Medicine or supplement | Medicamento o suplemento | Brand and generic name (active ingredient) |
| Dose | Dosis | Strength per pill and how many, e.g. 10 mg, 1 tablet |
| How often | Frecuencia | Once a day, twice a day, as needed |
| Reason | Motivo | What it's for |
| Prescribed by | Recetado por | Doctor's name, or "over the counter" |
| Pre-op instruction | Indicación prequirúrgica | Continue / pause from (date) / restart on (date), and who said so |
Add allergies alergias, including what reaction you had, at the top of the page. Use generic names where you can, because brand names differ between countries and a Colombian pharmacist or doctor is more likely to recognize the active ingredient.
On the morning of surgery, ask the anesthesiologist to go through your list with you in person. Confirm which medicines you took that morning and when you last took anything you were told to pause.
Frequently asked questions
Do I need to stop all supplements before surgery?
Not necessarily. Some may need a pause and others may be fine to continue. Give your surgeon and anesthesiologist a complete list with doses and follow the specific instructions they give you, in writing.
Should I stop my blood thinner before surgery abroad?
Never stop a blood thinner or antiplatelet drug on your own. Whether to pause it, for how long and whether you need a substitute must be decided by the prescriber who started it, together with your surgical team.
Can I take ibuprofen in the weeks before surgery?
Ask your surgeon and anesthesiologist. Anti-inflammatory painkillers can affect bleeding, so they may give you specific instructions or suggest an alternative. Tell them how often you take them now.
Does St. John's wort really matter for surgery?
Yes, mention it. St. John's wort is known to interact with many medicines by changing how they are processed. Your team needs to know about it, and you shouldn't stop or start it abruptly without asking.
Why does my medication list need to be in Spanish?
Your Colombian team may read English well, but nurses, pharmacists and emergency staff might not. A bilingual list with generic names reduces the chance of a misunderstanding.