Postoperative Medications: A Guide for Your Recovery
Understanding the purpose, common side effects and safety precautions of medications prescribed after orthopaedic surgery can help patients manage their recovery.
Your surgical team may prescribe medications to control pain and swelling, prevent infection or blood clots, and manage other postoperative symptoms. Not every patient requires every medication described in this guide. Your individual discharge instructions and prescription labels determine which medications you should take.
Questions About Your Recovery?
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Important: Review Your Medications Before Taking Your First Dose at Home
Although your surgical team works carefully to coordinate postoperative prescriptions with your regular medications, medication-list and prescribing errors can still occur. Review your discharge medication list alongside your existing medications before taking your first dose.
If you already take a chronic blood thinner or anticoagulant, such as Eliquis (apixaban), Xarelto (rivaroxaban), warfarin, Pradaxa (dabigatran) or Lovenox (enoxaparin), do not automatically add prescribed aspirin or another blood thinner. Contact your surgeon or prescribing team to confirm your individualized plan. Do not stop your regular blood thinner without medical guidance.
If your discharge paperwork, prescription bottle and medication instructions disagree, clarify the correct regimen with your surgeon or pharmacist before taking the uncertain dose.
Part 1: Commonly Prescribed Postoperative Medications
These are medications patients commonly ask about after surgery. You may receive only some of them, depending on your procedure and individual needs.
Non-Opioid Pain Relief
Acetaminophen (Tylenol)
Why you may receive it: Acetaminophen is a first-line pain reliever that helps control discomfort and may reduce the need for stronger opioid medications. It does not significantly reduce swelling.
Common side effects: Usually well tolerated, although occasional nausea or stomach upset may occur.
Important precautions: Excessive acetaminophen can damage the liver. Do not combine different tablet strengths or multiple acetaminophen-containing products without checking your total daily dose. Unless instructed otherwise, stay at or below 3,000 mg daily from all sources. Ask your healthcare provider about a lower limit if you have liver disease or regularly consume alcohol.
Anti-Inflammatory Pain Relief (NSAID)
Meloxicam (Mobic)
Why you may receive it: Meloxicam reduces inflammation, swelling, stiffness and pain in tissues around the surgical area.
Common side effects: Heartburn, stomach upset, nausea, swelling or fluid retention.
Important precautions: Take with food. Do not add ibuprofen (Advil/Motrin) or naproxen (Aleve) unless your surgical team approves. NSAIDs may irritate the stomach, cause bleeding, worsen kidney function or increase cardiovascular risk. Discuss any history of ulcers, kidney disease, dehydration or blood thinner use with your healthcare provider.
Stronger Pain Relief (Opioid)
Oxycodone
Why you may receive it: Oxycodone treats more severe pain that is not adequately controlled by other medications. It is generally intended for short-term use as pain improves.
Common side effects: Drowsiness, nausea, constipation, itching, lightheadedness and slower reaction time.
Important precautions: Do not mix oxycodone with alcohol. It can cause dependence and dangerously slowed breathing, especially when combined with gabapentin, methocarbamol, sleeping pills or other sedating medications. Do not drive while impaired, and store it securely away from children. Ask your healthcare provider whether naloxone (Narcan) should be available at home.
Newer Non-Opioid Prescription Pain Relief
Suzetrigine (Journavx)
Why you may receive it: Suzetrigine is a non-opioid treatment for short-term moderate to severe pain. It blocks certain pain signals in peripheral nerves and does not act on opioid receptors.
Common side effects: Itching, muscle spasms, rash or changes in a muscle-related blood test (CPK).
Important precautions: Avoid grapefruit. Journavx interacts with certain prescription medications and may affect the reliability of some hormonal contraceptives. Inform your pharmacist about all medications and birth control you use. Liver disease may require a different regimen.
Journavx: Important Information About the First Dose
Journavx requires a starting (loading) dose of 100 mg, followed by 50 mg approximately every 12 hours under the usual adult regimen.
At Northern Inyo Hospital and Mammoth Hospital, the usual clinical practice is to administer the 100 mg loading dose at the facility. Therefore, when you return home, you will generally take the prescribed single 50 mg maintenance tablets at the scheduled times, rather than taking another loading dose.
Confirm when your loading dose was administered. The first 50 mg maintenance dose is ordinarily due approximately 12 hours later. If you did not receive the loading dose, do not know when it was given, or have different discharge instructions, contact your care team or pharmacist before taking additional medication.
These facility instructions describe local prescribing practices and are not universal instructions for every hospital or patient. Correct loading-dose administration and timing are essential to using Journavx appropriately.
Nausea Relief
Ondansetron (Zofran – Standard Tablet or ODT)
Why you may receive it: Ondansetron treats nausea and vomiting, which may occur after anesthesia or opioid pain medications.
Common side effects: Headache, constipation or occasional dizziness.
Important precautions: The orally disintegrating tablet (ODT) dissolves on the tongue. Contact your care team if you cannot keep fluids down. Inform your doctor if you have a heart rhythm disorder or take other medications that affect heart rhythm.
Blood Clot Prevention
Low-Dose Aspirin
Why you may receive it: Aspirin helps reduce the risk of postoperative blood clots in selected patients. A deep vein thrombosis (DVT) forms in a leg vein, while a pulmonary embolism (PE) occurs when a clot travels to the lungs.
Common side effects: Upset stomach, heartburn, easier bruising or bleeding.
Important precautions: Take aspirin only if it is included in your individualized clot-prevention plan. If you already take a chronic anticoagulant, do not add aspirin without direct confirmation from your healthcare team. Aspirin combined with meloxicam or steroids can increase the risk of stomach bleeding. Do not discontinue prescribed clot prevention early without discussing it with your team.
Part 2: Other Medications for Reference
These medications may be used after certain procedures, in selected patients or for specific symptoms. They are not routinely appropriate for everyone.
Reducing Bleeding in Operated Tissues
Tranexamic Acid (TXA)
Why you may receive it: Tranexamic acid helps the body maintain clots that have formed at bleeding tissues by slowing their breakdown. In orthopaedic surgery, it may help reduce surgical-site bleeding, including bleeding into a joint (hemarthrosis) and related swelling.
Common side effects: Nausea, diarrhea, headache, or muscle and back discomfort.
Important precautions: Inform your surgical team if you have kidney disease, a history of blood clots, or use hormonal contraception or medications that affect clotting. Certain medical conditions and medication combinations may make TXA inappropriate. New vision changes require prompt assessment.
Why Might I Receive TXA and a Medication That Prevents Clots?
Although this may seem contradictory, these medications act on different parts of the clotting process for different purposes.
TXA slows the breakdown of clots that have already formed and is used to reduce bleeding into operated tissues or joints. Aspirin or Lovenox reduces the risk of harmful clots forming in leg veins or traveling to the lungs (DVT/PE).
A patient may appropriately receive TXA together with prescribed postoperative clot prevention. However, TXA is not exclusively local in its action, and its safety depends on the patient's clotting history, medications and other risk factors.
Follow the exact plan established by your surgeon and medical team. TXA does not replace aspirin, Lovenox or another prescribed DVT-prevention medication.
Alternative Blood Clot Prevention
Enoxaparin (Lovenox)
Why you may receive it: Enoxaparin is an injectable anticoagulant used to lower blood clot risk after certain operations or in patients with additional clotting risk factors.
Common side effects: Bruising or discomfort at the injection site, and easier bleeding or bruising.
Important precautions: Follow your injection instructions carefully. Kidney disease may require a dose adjustment. Do not combine Lovenox with aspirin or a chronic blood thinner unless the exact combination has been specifically prescribed and confirmed.
Additional Pain and Swelling Medications
Gabapentin (Neurontin)
Why you may receive it:Gabapentin may help manage burning, shooting or nerve-related discomfort after surgery.
Common side effects:Sleepiness, dizziness, fatigue, unsteadiness or difficulty concentrating.
Important precautions: Gabapentin can increase the risk of falls and dangerous sedation when combined with oxycodone, methocarbamol or alcohol. Kidney disease may require a lower dose, and older adults may be more sensitive.
Methocarbamol (Robaxin)
Why you may receive it: Methocarbamol may relieve painful muscle tightness or spasms around the operative area.
Common side effects: Sleepiness, dizziness, nausea or blurred vision.
Important precautions: Avoid alcohol and use extra caution when taking oxycodone or gabapentin. Do not drive while drowsy. This medication may be prescribed only as needed.
Dexamethasone (Decadron)
Why you may receive it: Dexamethasone is a short-course steroid that can reduce inflammation, pain, swelling and nausea.
Common side effects: Difficulty sleeping, increased appetite, mood changes, heartburn or increased blood sugar.
Important precautions: It is often taken in the morning with food. Patients with diabetes should follow their glucose-monitoring instructions. Combining dexamethasone with NSAIDs may increase stomach irritation or bleeding risk.
Stomach and Bowel Support
Omeprazole (Prilosec)
Why you may receive it: Omeprazole reduces stomach acid and may be prescribed during a course of meloxicam or steroids to reduce stomach irritation.
Common side effects: Headache, nausea, stomach discomfort, diarrhea or constipation.
Important precautions: Omeprazole reduces stomach acid but does not completely prevent ulcers or bleeding. Report black stools, vomiting blood or severe abdominal pain.
Docusate Sodium (Colace)
Why you may receive it: Docusate is a stool softener sometimes used to manage constipation after surgery, particularly when opioid medications are prescribed.
Common side effects: Mild cramping or loose stools.
Important precautions: Staying hydrated, maintaining an appropriate diet and moving as permitted by your surgeon can also help. Opioid-related constipation may require additional treatment, such as polyethylene glycol or senna. Contact your healthcare provider if you experience severe abdominal pain, vomiting or an inability to pass gas.
Antibiotics / Selected Infection Prevention
Oral antibiotics are not necessary after every surgery. If prescribed, take them exactly as directed. Contact your surgical team if you develop a concerning rash or significant diarrhea. Severe watery diarrhea can occur even after antibiotic treatment has ended.
Cephalexin (Keflex)
Why you may receive it: Cephalexin is a cephalosporin antibiotic used for certain skin or wound-related bacterial infections and for prophylaxis when indicated.
Common side effects: Nausea, mild diarrhea or rash.
Important precautions: Inform your healthcare team about any serious penicillin or cephalosporin allergies.
Cefadroxil (Duricef)
Why you may receive it: Cefadroxil is a cephalosporin antibiotic sometimes selected for postoperative wound-infection prevention.
Common side effects: Upset stomach, diarrhea or rash.
Important precautions: Report an allergic reaction or severe diarrhea.
Doxycycline
Why you may receive it: Doxycycline is an antibiotic selected in certain circumstances, including when specific bacterial coverage is desired.
Common side effects: Heartburn, nausea, diarrhea or increased sun sensitivity.
Important precautions: Take with a full glass of water and remain upright for 30 minutes. Calcium, iron, magnesium and antacids can reduce absorption. Ask your pharmacist how to space these products.
Trimethoprim-Sulfamethoxazole (Bactrim DS)
Why you may receive it: This antibiotic may be selected as an alternative for certain infections or prophylactic situations.
Common side effects: Nausea, rash, upset stomach or sun sensitivity.
Important precautions: Inform your healthcare team about sulfonamide antibiotic allergies, kidney disease or medications that increase potassium. A spreading rash, blisters or mouth sores require urgent evaluation.
Clindamycin (Cleocin)
Why you may receive it: Clindamycin is an antibiotic sometimes selected when other agents are unsuitable.
Common side effects: Nausea, abdominal discomfort or diarrhea.
Important precautions: Clindamycin has a notable risk of C. difficile intestinal infection. Contact your healthcare team promptly if you develop frequent watery diarrhea, fever or abdominal cramps, even after completing the medication.
When to Get Help
Call 911 or Seek Emergency Care
Seek emergency medical attention for:
- Sudden shortness of breath, chest pain, fainting or coughing up blood, which may indicate a pulmonary embolism.
- Very slow breathing, severe unresponsiveness or inability to wake someone after opioid or sedating medications. Use naloxone if available.
- Swelling of the tongue or throat, difficulty breathing or a severe allergic reaction.
- Major or uncontrolled bleeding, vomiting blood or severe symptoms associated with black stools.
Contact Your Surgical Team Promptly
Contact your healthcare team if you experience:
- New or worsening one-sided calf pain or swelling.
- Increasing redness, fever, wound drainage or wound separation.
- Unusual bruising or bleeding.
- Persistent vomiting or severe diarrhea.
- Pain that is not controlled by your prescribed plan.
- Unclear medication directions, duplicate prescriptions or conflicts with medications you already take.
Remember
Your individual discharge medication list takes priority over this educational guide. Not all medications described here should be taken together.
Never independently add aspirin or another clot-prevention medication to a chronic anticoagulant regimen. Do not change your regular medication or blood thinner therapy without consulting your medical team.
When in doubt, contact your surgeon or pharmacist before taking an uncertain medication dose.
For a consolidated list of postoperative medications, including dosage and prescribing options, see the Medication Reference.
