Medication Instructions

Please read these instructions carefully

Please have all of your prescriptions filled in advance and bring them to your surgical appointment. We will review them with you. Take your medication as directed. Please inform Dr. Rayher of all prescription and non-prescription medications that you take. Do not take any other prescribed or non-prescribed medications without discussing with Dr. Rayher. If you have any questions, please ask us. We can be reached at (415) 397-1400.

In certain instances, Dr. Rayher will prescribe pain relievers not listed below. If your medication is not listed, please follow the directions on the bottle and read the section Further Information about Medications at the end of these instructions. Dr. Rayher will also review the medication with you.

FOR FEMALE PATIENTS ONLY

If you are pregnant, possibly pregnant, or breastfeeding, please inform Dr. Rayher. Surgery, anesthesia, and/or medications may potentially complicate the pregnancy or harm the fetus. Please contact your physician if you wish to rule out pregnancy before surgery. If you are pregnant or breastfeeding, please contact your physician to determine which medications will be safe for you and the baby.

PAIN RELIEVERS – Mild to Moderate Pain

Keeping you comfortable during your recovery is very important to us. Proper use of pain medications is critical to help keep you comfortable. Please inform Dr. Rayher if you have had any previous problems or bad experiences with pain medication. If your pain is not controlled, please call the office or Dr. Rayher any time for help. Please read important information about your prescribed medications, including precautions and possible side effects, below.

• Ibuprofen prescription strength (600 mg tablets): Take 1 tablet by mouth up to 4 times a day. After surgery, you should plan to take ibuprofen regularly at breakfast, lunch, dinner, and bedtime. You should continue this schedule as long as you are having pain or your jaw is stiff. Taking the ibuprofen on a regular schedule will help speed your recovery, improve your comfort, and minimize your need for stronger pain relievers. Once your pain and jaw stiffness have resolved, the ibuprofen may be taken only as needed every 6 hours. Do not exceed more than 4 ibuprofen tablets in one 24 hour period.

PAIN RELIEVERS – Moderate to Severe Pain

The following drugs all contain a narcotic. Narcotic pain medications provide good pain relief but do have side effects. Please read the section Further Information about Medications at the end these instructions. These medications should be taken in addition to (not in substitution of) ibuprofen for improved relief. Unless otherwise instructed, do not take the narcotic pain relievers without also taking ibuprofen.

• Hydrocodone/acetaminophen (Norco) or Tylenol with Codeine (Tyco #3): Start with 1 tablet by mouth every 4 hours as needed for pain. You may start with a ½ tablet if you are prone to stomach upset. If 1 tablet is insufficient, you may increase to 2 tablets every 4 hours or 1 tablet every 2 hours as needed for pain. Do not exceed 12 tablets in a 24 hour period. If your pain is not relieved by 2 tablets every 4 hours, you need to call the office or Dr. Rayher for help.

ANTIBIOTICS – Infection or Prevention of Infection

Antibiotics are not prescribed routinely but on a case-by-case basis. If Dr. Rayher prescribes you antibiotics, have the prescription filled and take the medication as directed. You may be asked to start your antibiotics before surgery. The following guidelines apply to all antibiotics. Additionally, please read the section Further Information about Medications at the end these instructions.

• For antibiotics to work effectively, do not to miss doses and take the medication until gone.
• It is not unusual to develop some gastrointestinal upset. This may include upset stomach, bloating, cramping, gas, soft stools, or mild diarrhea. Some people find that eating yogurt with live cultures or taking probiotics helps with these symptoms. You may wish to consult your physician or pharmacist.
• If you develop diarrhea that is watery or bloody, discontinue your antibiotics and contact Dr. Rayher promptly.
• Oral contraceptives may be less effective after taking antibiotics. If you are taking oral contraceptives to avoid unwanted pregnancy, you should use an alternative method of birth control during the remainder of the cycle in which antibiotics are used. If you have questions, please ask the doctor who prescribed your oral contraceptives.
• Vaginal itching or discharge is not uncommon after taking antibiotics. This may represent a vaginal yeast infection. You will need to be evaluated and treated by your primary care physician or gynecologist.

FURTHER INFORMATION ABOUT MEDICATIONS

All medications, including both prescription and over-the-counter, have possible side effects, adverse reactions, allergic reactions, and potential drug interactions. Please inform Dr. Rayher of all the medications you are taking and all substances to which you are allergic. If you have questions or concerns, please review these with Dr. Rayher. You may also wish to consult your physician or pharmacist. Remember, keep all medications out of the reach of children, never share your medications with others, and use your medications only in the manner directed and for the indication prescribed.

Pain Relievers Containing Narcotics

Examples: Vicodin (hydrocodone/acetaminophen), Tylenol with codeine, Darvocet (propoxyphene/acetaminophen), Percocet (oxycodone/acetaminophen) and other strong pain relievers.

Precautions:

• These medications may impair your thinking or reactions required for the performance of hazardous tasks such as driving a car or operating machinery.
• Inform the doctor if you drink more than 3 drinks per day or if you have any liver disease.
• Do not take these medications if you suffer from an untreated or inadequately treated depressive disorder or if you are at risk for suicide.
• Do not combine these medications with other sedative medications.
• Do not drink alcohol while taking these medications.
• Do not use any medications for colds or allergy, pain relievers, sleeping pills, muscle relaxers, antidepressants, or seizure medications while taking pain relievers without first asking your doctor or pharmacist.

Adverse Reactions:

• The most frequently observed reactions include lightheadedness, dizziness, sedation, nausea, and vomiting.

Drug Abuse and Dependence:

• Psychic and physical dependence and tolerance may develop upon repeated administration of narcotics. This is unlikely to develop when used for a short period of time for treatment of pain.

Antibiotics

Examples: penicillin, amoxicillin, clindamycin

Precautions:

• Advise Dr. Rayher of any history of allergies or adverse reactions to any antibiotic.
• Advise Dr. Rayher if you have colitis, Crohn’s disease, or other intestinal disorder.
• Oral contraceptives may be less effective after taking antibiotics. If you are taking oral contraceptives, you should use an alternative method of birth control during each cycle in which antibiotics are used. If you have questions, please ask the doctor who prescribed your oral contraceptives.
• If the symptoms for which you were prescribed the antibiotics do not improve within a few days, or if they become worse, contact Dr. Rayher.

Adverse Reactions:

• The most common reactions to antibiotics include nausea, vomiting, abdominal or stomach cramps, loose stools, skin rash or itching, darkening of the tongue, oral thrush, and vaginal yeast infections.
• If you develop diarrhea that is watery or bloody, discontinue your antibiotics and contact Dr. Rayher promptly.

Proper Use of Antibiotics:

• Most oral antibiotics are best taken with a full glass (8 ounces) of water with or without food.
• Continue taking your antibiotics for the full time of treatment advised even if you feel better.
• Do not miss doses.
• For additional information, speak with your pharmacist.

Allergic Reactions

• Get emergency medical help immediately and then contact Dr. Rayher if you have any of these signs of an allergic reaction: difficulty breathing; swelling of your face, lips, tongue, or throat; severe skin rash or blistering.
• Contact Dr. Rayher if you develop mild skin rash or itching.

Please call our office if you have any questions.