Pre-Injection Instructions

1. Blood Thinners

You must stop blood thinners before any spinal injection. Coordinate with your prescribing provider to confirm it is safe to stop. Resume medication after the injection unless instructed otherwise.

Discontinue the following before your procedure:

• Lovenox (enoxaparin) – 12–24 hours
• Integrilin (eptifibatide), Aggrastat (tirofiban) – 1 day
• Pletal (cilostazol), Trental (pentoxifylline) – 2 days
• Eliquis (apixaban), Savaysa (edoxaban), Xarelto (rivaroxaban), Pradaxa (dabigatran) – 3 days
• Arixtra (fondaparinux) – 4 days
• Aspirin, Warfarin (coumadin), Reopro (abciximab), Brilinta (ticagrelor) – 5 days
• Aggrenox (dipyridamole), Plavix (clopidogrel), Effient (prasugrel) – 7 days
• Ticlid (ticlopidine) – 14 days

2. Notify Your Provider If You:

• Are or may be pregnant
• Are allergic to anesthetic, steroids, radiologic dye, or latex
• Have diabetes or uncontrolled blood pressure

3. Eating Before Procedure

Stop eating 3 hours before your procedure unless diabetic—then discuss with your provider. Please hydrate up to 1 hour before your appointment.

4. Vaccines

Do not receive vaccines 2 weeks before or after steroid injections. Steroids may weaken your immune system.

5. Post-Injection Instructions

• Steroids may take 1–7 days to take effect
• Avoid submerging the injection site in water for 24 hours
• Limit vigorous physical activity
• Follow-up typically occurs 2–3 weeks after the injection