Medications to Stop Before a PRP Injection: NSAIDs, Aspirin & Tylenol
Updated: Aug 24
By Dr. Jeffrey Peng, MD · Updated August 2026
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Platelet-rich plasma (PRP) injections are a widely studied treatment for tendon conditions, plantar fasciitis, and osteoarthritis. One often-overlooked factor that can significantly influence outcomes is the medications you take in the weeks surrounding the procedure.
Certain medications — particularly NSAIDs and even low-dose aspirin — can impair platelet function and reduce the effectiveness of PRP. There are no formal guidelines on medication cessation before PRP, but the existing research provides clear practical guidance.
Why You Should Stop NSAIDs Before a PRP Injection
Most NSAIDs work by inhibiting platelet function. PRP relies on growth factors released by activated platelets. If those platelets are impaired, the therapeutic response can be blunted.
Common NSAIDs include aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, celecoxib (Celebrex), meloxicam (Mobic), and indomethacin. A systematic review by Kao et al. (2022) concluded that aspirin, acetaminophen, and nonselective NSAIDs should be considered for suspension before PRP because of their potential to diminish treatment effects. COX-2 selective NSAIDs such as celecoxib did not show a significant decrease in platelet aggregation in that review.
How Aspirin Affects PRP Growth Factor Release
A prospective laboratory study by Jayaram et al. (2019) examined the effect of low-dose aspirin on growth factor release from PRP. Healthy volunteers took 81 mg of aspirin daily for 14 days. Platelet counts remained unchanged, but the platelets could no longer release key growth factors (TGF-β1, VEGF, and PDGF). Even baby aspirin can render platelets functionally unable to drive the healing cascade that PRP depends on.
Do NSAIDs After PRP Also Hurt Outcomes?
Yes. A controlled study by Sok et al. (2022) in a rodent model of post-traumatic osteoarthritis showed that NSAID use after a biologic injection substantially reduced therapeutic efficacy. Animals that received naproxen after the injection (or both before and after) had greater cartilage degeneration, more bone spur formation, and increased pain compared with those that received no NSAIDs.
Interestingly, NSAID use only before the injection had a much smaller negative effect. The clearest harm occurred when NSAIDs were taken in the weeks following the injection.
Why Acute Inflammation Matters After PRP
The initial inflammatory response after PRP is not something to suppress — it is part of the healing process. A study in Science Translational Medicine (Parisien et al., 2022) showed that early suppression of inflammation with NSAIDs or steroids can prolong pain despite short-term relief. Blocking the acute inflammatory cascade interferes with the mechanism that makes PRP effective.
Can You Take Tylenol (Acetaminophen) Around PRP?
Acetaminophen is more nuanced. Some studies suggest it has antiplatelet effects; others do not. In practice, I generally allow patients to use acetaminophen for pain control around the time of PRP because most people cannot comfortably stop all NSAIDs for several weeks. For patients who can tolerate holding everything, avoiding both NSAIDs and acetaminophen is ideal. If pain relief is needed, low-dose acetaminophen as needed is a reasonable compromise.
How Long Should You Stop These Medications?
There are no definitive clinical trials on exact timelines. Based on the available evidence and clinical experience, I recommend:
Before the injection: Stop all NSAIDs at least 1 week beforehand (2 weeks is preferable when possible).
After the injection: Avoid NSAIDs for at least 2 weeks, and ideally up to 6 weeks. The longer you can stay off them, the better the results are likely to be.
Always review your specific medication list with your treating physician.
Bottom Line
The medications you take around the time of a PRP injection can meaningfully affect outcomes. NSAIDs inhibit platelet function and suppress the acute inflammatory response that PRP relies on. The best results occur when patients avoid NSAIDs both before and after the procedure. Acetaminophen remains a practical alternative for pain control when needed.
If you are considering PRP therapy or have questions about how to prepare, schedule a consultation.
References
1. Jayaram P, Yeh P, Patel SJ, et al. Effects of Aspirin on Growth Factor Release From Freshly Isolated Leukocyte-Rich Platelet-Rich Plasma in Healthy Men: A Prospective Fixed-Sequence Controlled Laboratory Study. Am J Sports Med. 2019;47(5):1223-1229. doi:10.1177/0363546519827294
2. Sok D, Raval S, McKinney J, et al. NSAIDs Reduce Therapeutic Efficacy of Mesenchymal Stromal Cell Therapy in a Rodent Model of Posttraumatic Osteoarthritis. Am J Sports Med. 2022;50(5):1389-1398. doi:10.1177/03635465221083610
3. Driver B, Marks DC, van der Wal DE. Not All (N)SAID and Done: Effects of Nonsteroidal Anti-Inflammatory Drugs and Paracetamol Intake on Platelets. Res Pract Thromb Haemost. 2020;4(1):36-45. doi:10.1002/rth2.12283
4. Kao DS, Zhang SW, Vap AR. A Systematic Review on the Effect of Common Medications on Platelet Count and Function: Which Medications Should Be Stopped Before Getting a Platelet-Rich Plasma Injection? Orthop J Sports Med. 2022;10(4):23259671221088820. doi:10.1177/23259671221088820
5. Parisien M, Lima LV, Dagostino C, et al. Acute Inflammatory Response via Neutrophil Activation Protects Against the Development of Chronic Pain. Sci Transl Med. 2022;14(644):eabj9954. doi:10.1126/scitranslmed.abj9954
Medical Disclaimer: This content is for educational purposes only and does not substitute for the medical advice of a physician. Always consult your healthcare provider before beginning any new treatment program. The information presented reflects the opinion of Dr. Jeffrey Peng and does not represent the views of his employers or affiliated hospital systems.
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