From the Guidelines
Taking Aleve (naproxen) right before total hip arthroplasty is not necessarily a significant concern, as the administration of NSAIDs on the evening before surgery does not have an effect on perioperative bleeding or complication rate, according to a study published in 2006 1. However, it is essential to consider the potential risks and benefits of taking Aleve before surgery. Aleve is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding during and after surgery. It also interferes with blood clotting, which is crucial for proper wound healing. Additionally, NSAIDs can interact with other medications used during anesthesia and pain management. If you've already taken Aleve, inform your surgeon immediately. They may need to take extra precautions to manage potential bleeding risks. In some cases, they might prescribe medication to counteract the effects of the NSAID. For pain management before surgery, consult your doctor about using acetaminophen (Tylenol) instead, as it doesn't affect blood clotting. After surgery, follow your surgeon's instructions for pain management, which may include prescribed opioids or other approved medications. Some key points to consider:
- The 2006 study suggests that NSAID treatment does not need to be discontinued for THA surgery 1.
- However, more recent guidelines for the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty do not provide specific recommendations for NSAIDs like Aleve 1.
- It is crucial to disclose all medications, including over-the-counter drugs and supplements, to your surgical team well in advance of any procedure to ensure your safety and optimal surgical outcomes.
- The decision to take Aleve before total hip arthroplasty should be made in consultation with your surgeon and anesthesiologist, taking into account your individual medical history and the potential risks and benefits.
From the FDA Drug Label
BOXED WARNING Cardiovascular Risk NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. WARNINGS CARDIOVASCULAR EFFECTS Cardiovascular Thrombotic Events Clinical trials of several COX-2 selective and nonselective NSAIDs of up to three years duration have shown an increased risk of serious cardiovascular (CV) thrombotic events, myocardial infarction, and stroke, which can be fatal.
The risks of taking Aleve (Naproxen) immediately before undergoing Total Hip Arthroplasty (THA) include:
- Cardiovascular risk: increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal 2 2
- Gastrointestinal risk: increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal 2 2 It is recommended to use the lowest effective dose for the shortest duration possible to minimize the potential risk for an adverse event 2.
From the Research
Risks of Taking Aleve (Naproxen) Before Total Hip Arthroplasty (THA)
- There are no direct studies on the risks of taking Aleve (Naproxen) immediately before undergoing Total Hip Arthroplasty (THA) in the provided evidence.
- However, studies have investigated the use of non-steroidal anti-inflammatory drugs (NSAIDs) and anticoagulants in patients undergoing hip arthroplasty 3.
- One study found that patients taking dabigatran etexilate with concomitant NSAID or acetylsalicylic acid (ASA) had a similar risk of major bleeding events compared to those taking dabigatran etexilate alone 3.
- Another study compared the efficacy and safety of aspirin with conventional therapy in preventing venous thromboembolism after hip arthroplasty for femoral neck fracture, and found that aspirin was noninferior to conventional therapy in preventing venous thromboembolism 4.
- A study on preoperative pain management found that tramadol use was associated with an increased risk of prolonged narcotic use following total hip arthroplasty, but was not associated with other postoperative complications 5.
- The use of aspirin as a thromboprophylaxis agent after hip and knee replacement has been shown to be effective and safe, with a similar risk of venous thromboembolism compared to enoxaparin or rivaroxaban 4, 6.
Bleeding Risks
- The risk of bleeding associated with NSAID use in patients undergoing hip arthroplasty is a concern, but studies have shown that the risk of major bleeding events is similar to that of anticoagulants alone 3.
- The use of aspirin as a thromboprophylaxis agent has been shown to be safe and effective, with a similar risk of bleeding events compared to enoxaparin or rivaroxaban 4, 6.