🩺 Bariatric Pre-Op Handout Generator

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Patient & Surgery

Medications to Hold

Check the medicines this patient takes. Adjust “days before” to match your protocol — each one becomes a dated instruction on the handout.

Warfarin (Coumadin)stop d before
Apixaban (Eliquis)stop d before
Rivaroxaban (Xarelto)stop d before
Dabigatran (Pradaxa)stop d before
Edoxaban (Savaysa)stop d before
Clopidogrel (Plavix)stop d before
Ticagrelor (Brilinta)stop d before
Prasugrel (Effient)stop d before
Aspirin (if instructed to hold)stop d before
Enoxaparin (Lovenox)stop d before
Other / bridging instructions
⚠ Do not advise stopping anticoagulants without confirming a bridging plan with the prescribing/managing provider.
Semaglutide (Ozempic / Wegovy)stop d before
Tirzepatide (Mounjaro / Zepbound)stop d before
Dulaglutide (Trulicity)stop d before
Liraglutide (Victoza / Saxenda, daily)stop d before
Oral semaglutide (Rybelsus, daily)stop d before
Other / special instructions
⚠ Held to reduce delayed gastric emptying / aspiration risk under anesthesia. Confirm timing against your anesthesia/society protocol.
Empagliflozin (Jardiance)stop d before
Dapagliflozin (Farxiga)stop d before
Canagliflozin (Invokana)stop d before
Ertugliflozin (Steglatro)stop d before
Combo product (e.g., Synjardy, Xigduo)stop d before
Other / special instructions
⚠ Held to reduce risk of euglycemic diabetic ketoacidosis (DKA) around surgery.
Combined oral contraceptive (estrogen-containing birth-control pill)stop d before
Contraceptive patch or ring (Xulane, NuvaRing)stop d before
Estrogen hormone therapy (HRT pill or patch)stop d before
Tamoxifen / raloxifene (confirm with oncology)stop d before
Other / special instructions
⚠ Estrogen raises blood-clot (VTE) risk around surgery. Counsel on non-estrogen contraception — pregnancy must be avoided for 12–18 months after bariatric surgery. Coordinate tamoxifen/raloxifene holds with the prescribing specialist.
Phentermine (Adipex-P, Lomaira)stop d before
Phentermine-topiramate (Qsymia)stop d before
Naltrexone-bupropion (Contrave)stop d before
Diethylpropion (Tenuate)stop d before
Other / special instructions
⚠ Stimulant weight-loss medicines can affect heart rate, blood pressure, and anesthesia. Confirm hold timing with your anesthesia team.
Fish oil / omega-3stop d before
Vitamin E (high-dose)stop d before
Ginkgo, garlic, ginseng (bleeding risk)stop d before
St. John's wortstop d before
Turmeric / curcumin (supplement doses)stop d before
Other herbal / "natural" productsstop d before
Other / special instructions
⚠ Many supplements increase bleeding risk or interact with anesthesia. When in doubt: stop it and tell us everything you take, including "natural" products.

Timing is individualized (usually scheduled around the dosing cycle). Check applicable agents and enter the exact plan below.

Adalimumab (Humira)
Etanercept (Enbrel)
Infliximab (Remicade)
Ustekinumab (Stelara)
Rituximab (Rituxan)
Methotrexate
Hold instructions (timing, last dose, when to resume)
⚠ Coordinate timing with the prescribing specialist (Rheumatology / GI / etc.).
Free text (one per line)

Pre-Op Diet

Lifestyle & Activity

ERAS & Pain Plan

Check the non-opioid options your patient will use. The full ERAS & opioid-sparing education prints automatically.

Scheduled acetaminophen (Tylenol)
Nerve block / local anesthetic at incisions
Gabapentin / pregabalin
IV / oral non-opioid (e.g., ketorolac in hospital, per surgeon)
Anti-nausea medicine
Walking, ice, repositioning, breathing exercises
Pre-op carbohydrate drink
Home pain plan — what to take and when (optional)
Add a “rescue / breakthrough” line (optional)

Other