Taking five or more medicines? A medication review before surgery helps your clinical team assess potential drug interactions, avoid duplicate treatments and plan around anaesthesia, fasting and recovery. From blood thinners and painkillers to weight-loss injections and herbal supplements, every product matters. Discover why an accurate medication list is essential, what to discuss at your preoperative assessment and how to prepare for private surgery in the UK or abroad through My Medical Gateway with confidence.
When you prepare for surgery, your attention naturally turns to the surgeon, the hospital and the recovery ahead. Yet one of the most useful things you can bring to your assessment is surprisingly ordinary: an accurate list of everything you take.
That includes the occasional painkiller, the weekly injection and the supplement you bought online. Each helps the clinical team understand how to plan your operation safely.
Five medicines: a signal to look closer
Taking five or more regular medicines is commonly called polypharmacy. It does not automatically mean you are overmedicated. Someone managing diabetes, heart disease and arthritis may need several treatments, each serving an important purpose.
The question is whether those medicines remain appropriate together, at their current doses, and during surgery.
A 2023 study in BJS Open examined 55,997 surgical patients and found that 32.3% had preoperative polypharmacy. Multiple medicines were associated with adverse outcomes, but the researchers cautioned that this could partly reflect underlying illness. The finding supports careful assessment; it does not prove that reducing the number of medicines makes surgery safer.
What a review actually does
NICE recommends a structured examination of medicines, involving the patient, to optimise treatment and minimise medication-related problems. Before surgery, this needs to connect with a specific plan for anaesthesia, fasting and recovery.
The team should establish what you actually take, why you take it and whether your records match reality. Mention side effects, missed doses and anything you have stopped yourself.
Importantly, the British National Formulary warns that losing control of an existing condition by stopping treatment can pose a greater risk than continuing it. Never stop prescribed medicines simply because an operation is approaching.
Small details can change the plan
Consider blood thinners such as apixaban. They protect against dangerous clots, but can increase bleeding risk. Whether treatment needs interruption depends on the procedure, kidney function and other clinical factors. The surgical team must balance these risks and provide individual instructions.
Or consider co-codamol, a familiar painkiller containing both codeine and paracetamol. If additional paracetamol is prescribed after surgery without recognising that overlap, an accidental overdose becomes possible. The UK Clinical Pharmacy Association specifically highlights this duplication risk.
Vitamins and herbal products belong on the list too. “Natural” does not mean irrelevant to anaesthesia: some products can interact with treatment or affect bleeding. Tell the team what you use and follow their advice.
Why weight-loss injections deserve a mention
Medicines such as semaglutide and tirzepatide, used for diabetes or weight management, can slow stomach emptying. The UK medicines regulator has warned about the potential for stomach contents to enter the lungs during general anaesthesia or deep sedation.
This does not mean everyone taking these medicines should cancel surgery or stop treatment. It means the anaesthetist needs to know. Report your medicine, dose, injection schedule and any digestive symptoms, and obtain instructions tailored to your circumstances.
There is also promising research. Southampton researchers have secured around £3 million from the National Institute for Health and Care Research for PRIMO, a programme investigating genetic testing within medication reviews for older adults.
The planned larger trial will involve more than 1,000 people aged 65 and over taking at least five regular medicines. It will explore whether genetic information can help tailor prescribing. This remains research, rather than a routine requirement before surgery.
Prepare your list before your suitcase
Ask your GP practice or pharmacist for an up-to-date medication list, then check it against what you actually use. Include names, strengths, doses and timing, plus non-prescription products, allergies and previous reactions.
Share it early with your chosen MMG treating hospital, at the same time you forward your diagnostic tests for a detailed clinical examination. If you do this well before you are likely to travel, there is time to resolve discrepancies and coordinate advice with the surgical team. Ask for written instructions covering which medicines to continue, any changes before surgery, and when interrupted treatments should restart. You can check this across your UK NHS GP.
For treatment abroad, bring an adequate supply in original packaging and a copy of the agreed plan. Ensure your NHS GP receives the discharge summary and details of medication changes.
Through My Medical Gateway, choosing a Treatment Package is the start of a clinical assessment, not a substitute for one. Your hospital needs the complete picture before confirming suitability and planning care.
A medication review turns a collection of prescriptions into a coordinated plan. Whether you take two medicines or twelve, that clarity is a practical contribution to safer surgery and a better-informed recovery.
Considering private surgery abroad?
Explore Treatment Packages with My Medical Gateway and share your full medication list with your chosen hospital during clinical assessment. Ask early about your medicines, recovery and follow-up, so you can plan your treatment with confidence.
Leave a Reply