Kratom before surgery is mainly a disclosure question. Your surgeon and anesthesia team need to know you use kratom before any procedure, and they decide what happens with your medicines and your kratom use. This page gives you what to tell them, which product details to have ready, and the questions to bring. It gives no stop date, because the timing depends on your surgery, your other medicines and your health history.
Should kratom be stopped before surgery?
That decision belongs to your surgeon and anesthesia team, working with your primary care clinician. WebMD’s kratom guide says that if you have been using kratom regularly for a while, you should not stop it abruptly without talking with your health care provider, and that a provider may be able to help you stop in a way that reduces the risk of withdrawal reactions. The same guide adds that stopping regular kratom use suddenly can lead to withdrawal, which may be life-threatening.
For background on what people commonly ask about the period after stopping, read Pain Care After Stopping Kratom, and bring any question about your own plan to your clinician first.
What should the anesthesia team know about kratom?
A 2023 article in the Journal of the Royal Thai Army Nurses by authors at Siriraj Hospital, Mahidol University, Challenges in Anesthesia Practice with Kratom, reports that kratom’s active ingredients, mitragynine and 7-hydroxymitragynine, affect the central nervous system in a manner similar to opioids. The article says high doses can have sedative effects, that kratom can inhibit the cytochrome P-450 enzyme so drug interactions may occur, and that anesthesia personnel should be especially cautious with patients who have a history of kratom use.
A 2025 Doctor of Nursing Practice scholarly project from Otterbein University, Final Scholarly Project on perioperative kratom care, states in its abstract that kratom acts as both an opioid receptor agonist and an alpha-2 adrenergic receptor stimulant. Its literature analysis, according to the abstract, indicates that kratom can lead to resistance to anesthetics, insufficient pain control, refractory hypertension and symptoms mimicking opioid withdrawal after surgery. The abstract also describes guidelines the project plans to test on 100 patients, so treat them as a proposal rather than an established protocol.
The practical point is that the abstract names non-disclosure as a problem, so tell the team about kratom even if your use feels minor or occasional. WebMD lists common side effects of kratom as constipation, dizziness, drowsiness, nausea or vomiting, and fast heartbeat, and less common serious effects as liver damage, seizures and psychotic-like behavior.
The medicine groups below are ones WebMD asks people to discuss with a provider before taking kratom. WebMD also says that the interactions between kratom and medicines are not fully understood.
| Medicine group | Examples WebMD names |
|---|---|
| Medicines that cause dizziness and sleepiness | Prescription pain medicines, sleep medicines, medicines for anxiety |
| Barbiturates | Butalbital, phenobarbital, primidone |
| Benzodiazepines | Clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan) |
| Muscle relaxants | Carisoprodol (Soma), cyclobenzaprine, metaxalone, tizanidine (Zanaflex) |
| Opioids | Codeine, fentanyl, morphine, oxycodone, tramadol |
| Street drugs | Cocaine, heroin, methamphetamine |
WebMD says it is unknown whether alcohol affects kratom, but the risk of serious side effects may increase if you drink alcohol while taking it. The FDA kratom page says that in rare deaths linked to kratom, kratom was usually used in combination with other drugs, and the contribution of kratom to those deaths is unclear.
The FDA’s kratom page says that in rare cases deaths have been associated with kratom use.
Which product details matter before surgery?
Your team will ask what you take, and the product itself changes the answer. Have the exact product name, form and ingredient list ready.
| Detail to have ready | Why it matters | Source |
|---|---|---|
| Form: leaf, capsule, powder, tea, liquid extract or concentrated 7-OH | The FDA says 7-OH is less than 2% of total alkaloid content in natural kratom leaves, yet has substantially greater mu-opioid receptor potency than mitragynine and morphine. WebMD says the product type can affect which chemicals are found in kratom. | FDA kratom page; WebMD |
| Amount of each chemical | WebMD says the amount of each chemical varies from product to product, and switching to a new bottle or brand may change the effects you have. | WebMD kratom guide |
| Label accuracy | WebMD says kratom products are not regulated and have not been tested to confirm they contain the ingredients on their labels. | WebMD kratom guide |
| Contaminants | The FDA has warned the public when some kratom products were contaminated with Salmonella and/or concerning levels of heavy metals. | FDA kratom page |
Bring the bottle or a photo of its label to the pre-op conversation. To see what to check on a label before you rely on a product, read Buying Kratom Online Safely.
Is kratom legal to use or buy in the United States?
This is information, not legal advice. As of October 17, 2026, the FDA’s kratom page says there are no prescription or over-the-counter drug products containing kratom or its known alkaloids legally on the market in the U.S., and that kratom is not lawfully marketed in the U.S. as a drug product, a dietary supplement, or a food additive in conventional food, under the Federal Food, Drug, and Cosmetic Act. The same page says states may have their own regulations or prohibitions, and that state health and law enforcement agencies are the best resource on applicable state laws. WebMD adds that some U.S. states have banned the sale of kratom.
Who should decide the medication plan before surgery?
Your surgeon and anesthesia team decide it, working with your primary care clinician. The UCLA Health medications to avoid before surgery guide says to review all your medications, over the counter and prescription, with your surgeon, and that no one should medicate themselves with any drugs without the knowledge of their primary care physician and surgeon. The same guide says many medications have no effect on surgery, and you may be counseled to continue them as usual.
Which medicines and supplements does the UCLA guide flag for review before surgery?
The UCLA list is mainly about medications and supplements that may affect blood clotting. The UCLA guide says many of these may have no effect on surgery, and that your surgeon must be told about all of your medications. The UCLA page does not show kratom among the items it lists.
| Group | Examples on the UCLA list |
|---|---|
| Anti-inflammatory pain relievers | Aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), celecoxib (Celebrex), meloxicam (Mobic) |
| Herbal supplements | Echinacea, fish oil, garlic, ginkgo biloba, ginger, green tea, kava kava, St. John’s wort, valerian, vitamin E, vitamin C (large doses) |
| Birth control and estrogen | Birth control pills, estrogen replacement, estrogen creams or patches |
| Blood thinners | Warfarin (Coumadin), clopidogrel (Plavix) |
How many days before surgery should I stop medicines or recreational drugs?
Ask your surgeon for the stop day for each medicine, supplement and substance, and ask for the answer in writing. Recreational drug timing is the same kind of question, and it belongs with your anesthesia team.
Can kratom cause pancreatitis?
WebMD does list stomach or belly pain as a possible sign of liver damage, so report any new belly pain to a clinician rather than deciding what it means yourself.
What the research cannot tell us
- Human research is limited. The FDA says there are few published reports from well-designed scientific studies in which kratom was administered to humans, and that a well-designed human abuse potential study has not yet been conducted.
- Long-term effects. WebMD says the actual effects of kratom are not well understood.
- Drug interactions. WebMD says the interactions between kratom and medicines are not fully understood.
- Product consistency. WebMD says the amount of each chemical varies between products, so one product’s effects may not match another’s.
- Surgery outcomes. The 2025 Otterbein project describes a planned study of 100 patients, and its abstract says outcomes are still to be analyzed.
For how to read the adverse-event and limitation sections of studies, see Clinical Study Safety Data.
What should I prepare for my pre-surgery visit?
Use this worksheet to organize your answers, then take it to your surgeon or anesthesia team.
| Topic | What to write down | Who answers |
|---|---|---|
| Kratom product | Product name, form (leaf, extract or 7-OH product), and the ingredient list from the label | Anesthesia team; pharmacist |
| Kratom use | How often you use it and when you last used it | Surgeon and anesthesia team |
| Other medicines and supplements | Every prescription, over-the-counter medicine, herbal product and supplement, including items from the lists above | Surgeon, primary care clinician, pharmacist |
| Alcohol and other drugs | Whether you drink alcohol or use other drugs, including street drugs | Anesthesia team |
| Withdrawal history | Any past times you stopped kratom and what happened | Primary care clinician and surgeon |
| Stop days | A written stop day for each item | Surgeon and anesthesia team |
| Pain plan | Your concerns about pain control during and after surgery | Surgeon and anesthesia team |
Questions to bring:
- Should I stop kratom before my surgery, and what should I do about it?
- Which of my medicines and supplements need a stop day?
- How will the anesthesia team plan around kratom and my other medicines?
- Who will give me the stop days in writing?
Your next step
Use the linked explanation earlier on this page, then take this worksheet to your surgeon or anesthesia team with the product label in hand. Any decision about stopping, timing or medicines is theirs to make with you.
By UltimateKratom.com Research Desk
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.
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