Should You Stop Your Autoimmune Medications Before Surgery? Here’s What Chicago Patients Need to Know

If you’re living with an autoimmune disease and facing an upcoming surgery, you’ve probably asked yourself: “Should I stop taking my medication first?”

It’s one of the most common — and most misunderstood — questions patients bring to their Chicago rheumatologist. The truth is, there’s no one-size-fits-all answer. The right decision depends on balancing two very real risks: infection and disease flare-ups.

Let’s break it down in plain language, so you can have an informed conversation with your care team.

Why This Decision Matters So Much

Surgery is stressful enough without worrying about your autoimmune condition. But the medications that keep your disease under control can also affect how your body heals and fights off infection after a procedure.

Making the wrong call — in either direction — can lead to complications, delayed recovery, or a painful flare that could have been avoided.

This is why arthritis treatment in Chicago increasingly emphasizes close coordination between your surgeon and your rheumatology specialist before any planned procedure.

The Two Competing Risks

Risk #1: Infection and Wound Healing

Not all autoimmune medications carry the same surgical risk.

• Steroids (especially at higher doses) clearly raise the risk of infection and can slow wound healing.
• Biologic medications may modestly increase infection risk, though research isn’t fully conclusive.
• Conventional DMARDs (like methotrexate) generally have a much smaller impact on surgical infection risk — and in many cases, patients can safely continue taking them.

Risk #2: Disease Flare-Ups

Here’s the risk many patients don’t think about: stopping medication for too long can cause your autoimmune disease to flare.

A flare can:

• Delay your surgical recovery
• Increase pain and inflammation
• Reduce mobility during healing
• Sometimes require high-dose steroids — which often carry more surgical risk than your usual medication would have

In other words, stopping treatment “just to be safe” isn’t always the safer choice.

So, What Should You Actually Do?

There’s no universal rule, but here are general principles your care team may use when planning autoimmune disease treatment around surgery:

• If your surgery is elective (planned in advance, not urgent), aim to schedule it when your autoimmune disease is well-controlled.
• Minimize steroid use around the time of surgery whenever possible.
• Continue conventional DMARDs like methotrexate in most situations, as advised by your provider.
• Briefly hold certain biologics — often just one scheduled dose — restarting once your incision is healing well with no signs of infection.

Why Coordination Between Providers Is Essential

Your rheumatologist understands your disease activity and medication history. Your surgeon understands the surgical risks involved. Neither should make this decision alone.

The safest approach is a shared plan based on:

• Your specific medication regimen
• Your current disease activity
• The type and urgency of your surgery

The Bottom Line

The goal isn’t to automatically stop every medication before surgery. It’s about finding the right balance — protecting you from infection while also protecting you from a disease flare.

If you have an autoimmune condition and a surgery on the horizon, don’t make this decision alone.

Ready to Plan Your Care With Confidence?

At Chicago Arthritis, our team specializes in rheumatology and regenerative medicine, helping patients navigate complex decisions like medication management around surgery. Whether you’re dealing with joint pain, autoimmune disease, or exploring options like PRP therapy for osteoarthritis treatment, we’re here to help you find real relief.

👉 Visit ChicagoArthritis.com to schedule a consultation and get a personalized plan for your care.

---

Why Repeated Steroid Use Means Your Autoimmune Disease Isn’t Controlled

Why You Might Still Feel Lousy on Autoimmune Medication

Can Arthritis Affect Your Eyes? Understanding Uveitis and Autoimmune Conditions