When the MHRA receives reports that herbal medicines, for example St John's wort, may interact with other medicines, we look carefully at the evidence and seeks the advice of the Committee on Safety of Medicines (CSM) . The objective is to take a balanced and proportionate approach.
Use of herbal medicines in patients prior to surgery
It is important for patients to discuss their herbal medicines with their doctor before they undergo surgery. In some cases it may be necessary to discontinue the herbal medicine several weeks before surgery.
Concerns have been raised that some herbal medicines should be discontinued prior to surgery. This is because it is thought that some herbal medicines could cause complications by interfering with anaesthetics, anticoagulants and other substances used before, during or after surgery.
There are also concerns that some herbal medicines may themselves interfere with blood clotting and blood pressure. For example, garlic, ginseng and ginkgo have been reported to interfere with blood clotting mechanisms and may increase the risk of bleeding during surgery.
Because of the limited information available on herbal medicines it is difficult to give specific guidance on when they should be discontinued prior to surgery.
Source: http://www.mhra.gov.uk
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