ThinnerTimes - Gastric Bypass and Lap Band® Forum - View Single Post - Taking meds post-op. Some things you need to know!

MiladyB · 10-11-2007, 05:19 AM

I know this has been discussed in a couple other threads but I wanted to highlight this information in it's own thread. I feel this is important information, people and we all have the respondsibility to be aware of it AND to educate the doctors that we deal with outside of our bariatric physicians.

So here is the latest information about meds, post-op.

There are certain pills that you should not be taking after surgery because they will either irritate your pouch, such as all pills in the NSAIDs catagory or pills that just won't be absorbed like they should. Any pills with enteric coating (kind of like a candy coating) or any extended release type med may not be absorbed like it is supposed to. If any of your meds do fall into those catagories you will want to get them changed. Those meds need the gastric juices to break them down and after RNY those juices just aren't there to do the job until well down your intestinal system which won't be enough time to break those meds down.

So basicly, you want to avoid any meds that are extended release, delayed, controlled, sustained or any medication that is an NSAIDs.

Over-the-counter NSAIDs are:
Aspirin, Motrin, Advil, Aleve, Orudis KT, Ibuprofen, Excederin

Prescribed NSAIDs are:
Motrin, Naprosyn, Anaprox, Toradol, Lodine, Feldene, Indocin, Daypro, Relafen, Voltaren and Celebrex.

There is the belief by some surgeons out there that even one NSAIDs can cause some kind of damage to your pouch and they strongly recommend staying away from them, if possible. If medically there is a reason to be taking them, such as the use of low dose asprin for heart conditions, it is okay to take them but you should also be placed on some kind of protectant such as Carafate or Cytotec.

If you are unsure if any of the meds you are on fall into any of these catagories talk to your Pharmacist, they will know. It isn't a bad idea to let your Pharmacist know that you are a Gastric Bypass patient. They can list it in your information almost like an allergy so that if you are ordered a med that you shouldn't be on an alert will be generated. There are ALOT of physicians out there that don't know this kind of information it is our respondsibility to make sure they are aware of it.

Here are 21 basic rules we should all follow in regards to our meds:

1. If side effects appear or increase, consult your doctor or your pharmacist about dosage or other medication options.

2. First-pass effect medications may not provide effective absorption at the currant dosages. Check dosage or check for alternative medications that do not have first pass effect. (your Pharmacist will know if any of your meds are "first-pass" meds)

3. Medications that are in a liquid or solution form will be absorbed faster than those that are solids. Check for liquid forms of medications.

4. No extended-release, sustained-release, controlled-release, timed-release or osmotic pump medications.

5. Many medications can also have gastrointestinal side-effects like gas, diarrhea, constipation or intestinal cramping.

6. Read the pamphlet attached to the prescription bag for potential side-effects.

7. You should not take any NSAIDs without a protectant such as Cytotec or Carafate. EVER!!!!

8. Be able to recognize an NSAIDs when you see one.

9. Use a protectant if taking daily low-dose aspirin for heart health or to prevent stroke.

10. Check all PMS over the counter medications (OTC) for NSAID ingredients.

11. Read all OTC medication packaging to check for NSAIDs ingredients.

12. Inhaled steroids for asthma are okay.

13. Taking steroids of any kind, even by injection, requires taking a protectant as well.

14. Medications commonly used in the treatment and prevention of osteoporosis such as Fosamax, Actonel and Boniva have the potential to cause gastrointestinal ulceration. Talk to your doctor or pharmacist about alternatives.

15. Do not continue to take medications that have been discontinued.

16. If dosages have been changed, do not finish out a previous dosage just because it is there. CHange the dosage immediately unless instructed otherwise by your physician.

17. Ask your doctor or pharmacist if any of your medications are fat soluble. If so, stay in touch with the prescribing physician and report your currant weight every month for possible dosage changes. (as the amount of fat in your body changes your dosages may also need to be changed)

18. Tell all medical providers about your status as a weight loss surgery patient. (Lap-Banders too!)

19. Keep all your scripts at one pharmacy if possible.

20. Meet and get to know your local pharmacists. They truly can be invaluable friends.

21. Remember to have everyone work as a team for you! You're worth it!

(Used with permission of Little Victories Medical/Legal Consulting & Training. All rights reserved)

One other word of warning when it comes to taking Tylenol. You MUST watch the amount of Tylenol you are taking. No more than 4,000mg in a 24 hour period. You can cause yourself liver damage with Tylenol overdose. You need to read your labels. Look to see if things have Tylenol or acetamenophin in them. Vicodan has Tylenol so if you are taking Vicodan or Lortab make sure you aren't adding a lot of Tylenol on top of it. That is why it is important to read the information on those pharmacy bags and on otc medications.