Surgery on Biologics?

[CCannon48]

How long is one to be off RA biological like Cimzia before having major surgery like a hip replacement?

Should people stop biologics before routine colonoscopies?

Thanks

[helixhelix]

Your rheumatologist should advise you as although there are broad guidelines these need to be adjusted to take account of your general health, age etc etc. So no hard and fast rule.

As for a colonoscopy I can't imagine that you need to change anything as such a minor procedure and no incisions. I'm not on a biologic but have had a colonoscopy and polypectomy recently and was told to stick with my current meds.

[hawker955]

Cannon48,

I was told six weeks for my biological and I assume that all are the same. So six weeks before and after surgery. This is particularly important if the surgery involves an implant, which mine did. Check with your rheumatologist but you don't want your implant to become infected and have to undergo a repeat procedure.

[CCannon48 in reply to hawker955]

Yes - rather be safe.

[Eiram50]

I have been on a couple of biologics when facing surgery. I had both hips replaced, followed by both knees replaced and for both operations, I had to stop my biologic a week before surgery? Restarting 10-14 days after surgery.

As HH has said, you should be guided in this and I’d agree, it’s highly unlikely that you would need to stop them at all for such a procedure ( colonoscopy )- but best to talk to your medical team .

Marie

[Amy-N-S]

I’m on Cimzia. Due to have surgery this week. Rheumy told me to come off 2 weeks before surgery (though because my op date didn’t sync with my fortnightly injection schedule, it will actually be three-and-a-bit weeks) and restart 2 weeks after surgical wound has healed,

[CCannon48 in reply to Amy-N-S]

Good to know so I can plan ahead for when I have surgery. Only started Cimzia 3 months ago.

[Paula-C]

What different information we are given, I had cataract surgery last April. I’m on enbrel and was told to stop it three weeks before and re start it two weeks after if everything was alright. Was worried about stopping it for that length of time but was okay, I’m in remission though.

[Bully915]

Hi hope this is of use I am on benepali and had to stop 2 weeks before op on elbow but was told I could start right away after op the guidelines say 2 weeks before and 2.weeks after good luck with op

[medway-lady]

i've just had an operation and advised to carry on taking medications as the danger of a flare is more than the length of healing time which is mimimal. A colonoscopy no but the special diet is just weird ! The surgeon will advise you as did mine.

I understand fro my surgeon in September guidlelines recently changed so be guided by the professionals. I'd add I've had no problem but am in a flare at the moment and advised that any stress like an op etc can do that. Its not too dreadful but going for a steriod jab later in the week.

[CCannon48 in reply to medway-lady]

Will look for new guidelines. Just do not want to risk post op infection or any issues with healing.

[CCannon48]

Thanks!

[hawker955 in reply to CCannon48]

lease note that I was not permitted to even receive acupuncture because of the susceptibility to introduced infection. Therefore surgery is obviously more invasive and a more serious threat. I sustained infection after emergency surgery in 2012 when I received an implant without stopping the Humira. It was not fun! I t\ake the hazards seriously as a result!

[CCannon48]

Thanks for sharing- I do not want to take any chances with infection. I was considering acupuncture so glad you mentioned that. I actually had several areas of skin infection from acupuncture in the past even before Cimzia.