MEDICATION LIST

Medications Which Increase Bleeding. Avoid Three weeks prior to surgery.

** If you must take medication for pain relief, please take Tylenol (as directed) **

PLEASE CHECK ALL MEDICATIONS YOU ARE TAKING FOR ASPIRIN CONTENT. IF YOU ARE TAKING A MEDICATION NOT LISTED BELOW, PLEASE CONTACT YOUR PHARMACIST OR CALL THE OFFICE: 949-640-0999

Advil
Aggrenox
Aleve
Alka Seltzer
Alka Seltzer Plus Antacid
Alka Seltzer Cold Medicine
Alka Seltzer Pain Reliever
Antacids
Anaprox
Arthrotec
A.P.C. Tablets
A.P.C. Tablets w/Butalbital
A.P.C. Tablets w/Codiene
Arthritis Pain Formula
Athritis Strength Bufferin
Ascriptin
Ascriptin A/D
Ascriptin w/ Codiene
Aspergum
Aspirin Suppositories/Uniserts
Aspirin Tablets
Aspirin w/ Codiene
Atromid-S Clofibrate
Axotal
Azdone
Bayer Aspirin
Bayer’s Children’s Chewable
Tablets
Bayer Timed Released
BC Powder
BC Cold Powder
BC Powder Arthritis
Buff A Compound Tablets
Bufferin & Tri-Buffered
Bufferin
Buffered Aspirin
Buffez
Butalbital Compound
Cama Inlay Tablets
Cama Arthritis Tablets
Cataflam
CETA Sed Improved
Clinoril / Codoxy
Congesp
Cope
Coricidin “D”
Coricidin Demilets
Coricidin Tablets
Coumadin
Damason-P
Darvon Compound 65
Darvon w/ASA
Darvon N w/ASA
Daypro
Decongestant Tablets
Diet Medications
Dolobid
Dristan Decongestant
Tabs & Capsules
Duradyne
Easprin
Easprin Tabs & Caps
Empirin
Empirin w/ Codiene
Emprazil
Emprazil-C Tabs
EnTab
Equagesic
Equasine-M
Excedrin
Extra Strength Bufferin
Feldene
Fiornal
Fiornal w/Codiene
Fiorgen
Fortabs
Four Way Cold Tablets
Gelpirin
Genasyme
Genacote
Genprin
Gensan
Geocillin-Carbencillin
Goody’s Headaches
Powder / Goddy’s Extra Strength
Tablets
Halfprin
Heparin
Ibuprofen
Idenal
Indocin
Isoallele w/Coricidin
Lodine
Lortab ASA
Lovenox
Magnaprin
Magnaprin Arthritis
Strength Caplets
Maripirin
Meclofenamate
Medilates Tablets
for Children
Mepro-Analgesic
Micainin
Midol
Mobic
Momentum Muscular
Backache Formula
Monacet
Motrin
Nalfon
Naprosyn/Naproxen
Naprosyn
Naproxea
Norgesic
Norgesic Forte
Norwich Aspirin &
Extra Strength
Nuprin
Oradisc
Pabirin Buffered
Tablets
PA Caps
PAC Revised Formula
Pamprin / Panalgesic
Pepto-Bismo
Percodan Demi Tablets
Persantine-Dipyridamole
Persistin
Phen-fen
Phentermine(Diet Pills)
Plaquenil-Hydroxychloroquine
Plavix
Pletal
Ponstel
Propoxyphene Compound 65
Pulvules
Quiet World Analgesic
Relafen
Robazisal Tablets
Sine Off
SK-65 Compound Capsules
Sloprin
Soma Compound
St. Josephs’s Cold Tablets
St. Joseph’s for Children
Supac
Synalgos
Synalgos DO Capsules
Talwin Compound
Therapy Bayer
Tiolid
Tolectin
Toradol
Toradol
Trigesic
Triaminic
Vanquish Caplets
Verin
Vitamin E
Volteres
Zorpi

This is not a complete list. Please check with your pharmacist if you have any questions.

** Avoid Herbals Such As: Feverfew, Garlic, Ginger, Ginko Biloba, Ginseng, Siberian, St. john’s Wort, Evening Primrose oil, Kava Kava, Licorice, MaHong, Valerian **

****Do Not Drink Smoothies, Naked Juices, Jamba Juices, Etc…****

PATIENT’S SIGNATURE:______

RESPONSIBLE PARTY:______

TIME:______DATE:______

WITNESS:______