| Arnica | Reduce swelling and bruising. | Inhibits blood clotting. | May increase risk of bleeding or potentiate the effects of Warfarin therapy. | Discontinue at least 24 hours before surgery. |
| Echinacea | Boosts immunity. | Impairs wound healing & suppresses immunity if used long term. | Allergic reaction, impairs immune suppressive drugs, can cause immune suppression when taken long-term could impair wound healing. | Discontinue as far in advance as possible. |
| Garlic | Lowers cholesterol and BP. | Inhibits platelet aggregation & increases fibrinolysis. | Risk of bleeding, especially when combined with other drugs that inhibit clotting. | Discontinue at least 7 days before surgery. |
| Ginko Bioba | Improves circulation memory and alertness. | Inhibits platelet aggregation. | Risk of bleeding, especially when combined with other drugs that inhibit clotting. | Discontinue at least 36 hours before surgery. |
| Ginseng | Discontinue at least 36 hours before surgery. | Lowers blood glucose. Inhibits platelet aggregation. | Lowers blood sugar levels. Increase risk of bleeding. Interferes with warfarin. | Discontinue at least 7 days before surgery. |
| St. Johns Wort | Reduces anxiety, helps depression and sleep problems. | Inhibits re-uptake of neuro-transmitters (similar to prozac). | Alters metabolisms of other drugs such as cyclosporin, warfarin, steroids, protease inhibitors. May interfere with many other drugs. | Discontinue at least 5 days before surgery. |
| Feverfew | Inhibits blooding clotting. | Inhibits re-uptake of neuro-transmitters (similar to prozac). | May increase bleeding, especially in-patients already taking anticoagulants. | Discontinue at least 36 hours before surgery. |
| Dphdra | Suppress appetite. | Increase heart rate, increases blood pressure. | Risk of heart attack, arrhythmias, stroke, interaction with other drugs, kidney stones. | Discontinue at least 24 hours before surgery. |
| Kava | Reduces anxiety. | Sedates decreases anxiety. | May increase sedative effects of anaesthesia. Risks of addiction, tolerance and withdrawal unknown. | Discontinue at least 24 hours before surgery. |
| Valerian | Reduces anxiety and sedates. | Sedates. | Could increase effects of sedatives. Long term use could increase the amount of anaesthesia needed. Withdrawal symptoms resemble Valium addiction. | If possible, taper dose weeks before surgery. If not, continue use until surgery. Treat withdrawal symptoms with benzodiazepines. |
