Help Adjust Chronic Meds After Weight Loss Surgery
1.
Meds to avoid in bariatric patients
- Avoid Enteric-Coated or ER meds for at least 8 weeks after
surgery...due to possible erratic absorption
- Avoid GI
irritants: such as NSAIDS and biphosphonates
- Avoid systemic
corticosteroids
2.
Meds are safe to be used in bariatric patients
- Crushable tabs, caps that can be opened or liquids
- Liquid forms that are low in in sugar...to reduce the risk of
dumping syndrome (diarrhea, abdominal cramps)
- Advise adding
PPI if NSAID is necessary
3.
Meds to avoid in patients with diabetes
- Suggest stopping sulfonylureas: Glipizie, Glimeperide,
Glyburide
4.
Insulin in patients with diabetes
- Recommend stopping or reducing mealtime dose by at least
50%..and basal insulin by 50-70%
5.
Antihypertensives in bariatric patients
- Recommend reducing dose if needed
- But ensure meds for
comorbid conditions are continued...such as ACEI/ ARB for kidney
protection in pts with diabetes
6.
Warfarin dose in bariatric pts
- Anticipate seeing a lower dose for about 6 months after
surgery...partly due to less vitamin K intake
- Expect to
return to pre-surgery dose over several months.
- Dont
generally recommend using direct oral anticoagulant...due to limited
data
7.
Vitamin and mineral supplement
- Recommend lifetime adherence
8.
Bariatric pts with a gallblader
- Expect to be on Ursodiol for 6 months post-op....to prevent
gallstones due to rapid weight loss