Immunosuppressants/Steroids Before & After Surgical Weight Loss
NOTE: These are general guidelines, your surgeon may elect to use a different protocol so please discuss this with your specific provider. It is very important to have a plan in place when it comes to these medications, otherwise it could result in your surgery being canceled or delayed!
Steroids (prednisone, methylprednisolone, Medrol Dose-Pak, etc):
Sleeve/SIPS/Band:
- Ideally a patient will wean off chronic oral steroids (prednisone) completely by 4 weeks prior to surgery, and hold it for 4 weeks after surgery.
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- Short-term steroids such as a Medrol dose pack or intra-muscular injections need to be held for 4 weeks prior and 4 weeks after also.
- Injectable steroids in joints or epidural space need to be held for 2 weeks prior and 2 weeks after.
- Topical and/or inhaled steroids are ok and do not need to be stopped.
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Bypass:
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- Gastric bypass patients cannot take steroids ever, therefore if a patient takes chronic steroids they are not a candidate for the procedure at all.
- Short-term steroids such as a Medrol dose pack or intra-muscular injections need to be held for 4 weeks prior and 4 weeks after also.
- Injectable steroids in joints or epidural space need to be held for 2 weeks prior and 2 weeks after.
- Topical and/or inhaled steroids are ok and do not need to be stopped.
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Methotrexate: Ideally a patient will stop methotrexate 4 weeks prior to any weight loss surgery, and resume it 4 weeks after surgery. If the patient cannot tolerate a drug-free interval it is ok in certain cases to continue through and after surgery, as there is some literature to suggest it is safe.
Plaquenil: Ideally a patient will stop plaquenil 4 weeks prior to any weight loss surgery, and resume it 4 weeks after surgery. If the patient cannot tolerate a drug-free interval it is ok in certain cases to continue through and after surgery, as there is some literature to suggest it is safe.
TNF Inhibitors (Remicade, Humira, Enbrel, etc): These medications should be held for 1 dosing cycle. This translates to:
- Remicade: 6-8 weeks depending on dose
- Humira: 2 weeks
- Enbrel: 1 week
- TNF Inhibitors can be resumed 2 weeks after surgery.
If you take any of these medications and are unsure what you should do prior to surgery, please contact us at provider@curryweightloss.com!
