Should I stop any medications or supplements before my treatment?

In general, 7 days before your procedure we ask you to suspend anti-inflammatory painkillers, such as ibuprofen, naproxen, diclofenac, meloxicam, celecoxib, ketorolac or aspirin. Paracetamol (acetaminophen, Tylenol) and tramadol are the only painkillers that do not interfere with the procedure. 5 days before, stop natural anti-inflammatory supplements, such as omega 3, ginger and turmeric. Heart medicine and other controlled medications can usually be continued up to the day of your procedure, but you must tell us about them. Send us your full list of medications and supplements when you book, so the doctor can give you personalized instructions.

The days before your treatment matter. Some common medications and supplements can blunt the inflammatory signals that platelet-rich plasma (PRP) and mesenchymal stem cells use to support repair, or can increase bleeding at the injection site. This guide explains what to pause, what to continue and why, based on the instructions we give to every patient.

Why some medications are paused

Regenerative treatments work with the body's healing response. When PRP and mesenchymal stem cells (MSCs) are applied, they release and respond to signals, such as growth factors and cytokines, that organize repair. Some medications interfere with this process:

• Anti-inflammatory drugs (NSAIDs) block enzymes involved in inflammation. The early, controlled inflammatory response after an injection is part of how PRP and MSCs act, so NSAIDs can reduce their effect. NSAIDs also affect platelet function, and platelets are the active ingredient of PRP.
• Corticosteroids are powerful anti-inflammatory drugs. Laboratory research has shown that some corticosteroids can be toxic to mesenchymal stem cells, which is why the timing of steroid injections near the treated area matters.
• Supplements with anti-inflammatory or blood-thinning effects can have a similar, milder effect, and some increase the risk of bruising.

The International Olympic Committee (IOC) consensus paper on PRP in sports medicine discusses how platelets release growth factors to start healing, which helps explain why medications that affect platelets and inflammation are paused around these treatments.

7 days before your procedure

Suspend anti-inflammatory drugs and painkillers such as:

• Celecoxib
• Etoricoxib
• Diclofenac
• Ketorolac
• Meloxicam
• Ibuprofen (Motrin, Advil)
• Naproxen
• Indomethacin
• Sulindac
• Piroxicam
• Metamizole
• Aspirin

Notify our medical team if you take any of these medications. If you need pain relief during this week, paracetamol (acetaminophen, Tylenol) and tramadol are the only painkillers that do not interfere with the procedure.

Important: aspirin and blood thinners

If you take aspirin prescribed by your doctor for heart or stroke prevention, or a blood thinner such as warfarin, apixaban, rivaroxaban or clopidogrel, do not stop it on your own. Tell our medical team, and talk to the doctor who prescribed it. The decision to pause or continue these medications depends on your individual risk, and our doctor will coordinate the safest plan for you.

Important: tramadol is not right for everyone

Tramadol is an option for pain relief during this week, but only if it is appropriate for you. According to MedlinePlus, from the U.S. National Library of Medicine, tramadol can interact with several medications, including monoamine oxidase (MAO) inhibitors, such as selegiline, which is used in Parkinson's disease, and some antidepressants, increasing the risk of a serious reaction called serotonin syndrome. It can also increase the risk of seizures in some people. If you take medication for Parkinson's disease, depression or anxiety, or have a history of seizures, ask the medical team before taking tramadol. Paracetamol is usually the simplest option.

5 days before your procedure

Stop natural anti-inflammatory substances, such as:

• Omega 3 (fish oil)
• Ginger
• Turmeric (curcumin)
• Any other supplement taken for its anti-inflammatory effect

If you take other supplements, such as high-dose vitamin E, ginkgo or garlic supplements, include them in your list. Some of them have blood-thinning effects, and the doctor may ask you to pause them as well.

What you can usually continue

• Heart medicine, such as blood pressure medication, can usually be continued up to the day of your procedure. Let us know what you take.
• Other controlled medications, such as thyroid medication, diabetes medication or medication for chronic conditions, can usually be continued. Tell us about them.
• Paracetamol (Tylenol) for pain.

If in doubt, do not decide without consulting first. In our instructions, we remind patients that failing to follow them can affect the results.

Corticosteroids

Tell us if you have received, or take:

• Steroid injections in a joint or the spine, such as cortisone shots or epidurals.
• Oral steroids, such as prednisone.
• Inhaled or topical steroids.

The doctor will tell you whether any timing adjustment is needed. Do not stop oral steroids suddenly without medical advice, since some must be reduced gradually.

Diabetes medication

If you have diabetes, tell the team about your medication. On the morning of your procedure you will be fasting, and the doctor may adjust the timing of some diabetes medications to avoid low blood sugar.

After your procedure

The restrictions usually continue for a period after your treatment. You will receive written aftercare instructions before discharge, including when you can resume anti-inflammatory medications and supplements. For pain after the procedure, paracetamol is usually recommended, and the team can give you medication for discomfort during your night at our facilities if needed.

Other substances to pause

Medications and supplements are not the only things that affect your treatment. Our pre-treatment instructions also ask you to:

• 7 days before: suspend tobacco products and cigarettes, alcohol, cannabis in any form and carbonated soft drinks, and drink plenty of water.
• 5 days before: avoid dairy products, fatty meals and breaded or fried foods.
• 1 day before: drink at least 1 liter of water between 3:00 pm and 9:00 pm.
• The day of your procedure: come fasting and keep drinking water from the moment you wake up until you arrive at the clinic.

Smoking reduces blood flow and oxygen in the tissues, and alcohol and cannabis can interact with medications used around the procedure. Following these steps together with the medication instructions helps your body respond to the treatment.

How to share your medication list

When you book, send your advisor a complete list with:

• The name of each medication and supplement.
• The dose and how often you take it.
• The reason you take it.
• Any recent injections, especially steroids.

The doctor reviews the list and confirms which items to pause, which to continue and for how long. If anything changes after you send it, such as a new prescription, let your advisor know before your trip.

Summary table

Common questions

I forgot and took ibuprofen 4 days before. What should I do? Tell your advisor right away. The doctor will tell you whether your plan needs any adjustment.

Can I take my vitamins? Most basic vitamins, such as a daily multivitamin, vitamin D or vitamin B12, can usually be continued, but include them in your list so the doctor can confirm.

Can I take a sleep aid the night before? Tell the team what you take, including over-the-counter sleep aids, and the doctor will advise you.

Do these instructions apply to IV treatments too? Yes. The general instructions apply to all our stem cell treatments, and the doctor can personalize them.

Questions to ask the medical team

• Which of my medications should I pause, and for how long?
• Is tramadol safe with my other medications?
• When can I restart my anti-inflammatory medication after treatment?
• Do I need to adjust any medication on the morning of my procedure?

Bottom line

Pause anti-inflammatory painkillers 7 days before and natural anti-inflammatory supplements 5 days before your procedure. Use paracetamol, or tramadol if it is appropriate for you, for pain. Continue your heart and other controlled medications unless the doctor says otherwise, and never stop prescribed aspirin, blood thinners or steroids on your own. Send us your full list so the doctor can give you personalized instructions. A medical evaluation can help determine whether this type of regenerative treatment is appropriate for your condition, goals and medical history.