Before neuromodulator therapy of any type, avoidance of medications and herbal supplements that increase the risk of bleeding is advised to prevent injection site bruising. Avoid these frequently used products/supplements for one week before therapy, if possible: Any aspirin containing over-the-counter product, NSAIDs (nonsteroidal antiinflammatory drugs) like ibuprofen and naproxen, rantidine (Zantac), as well as herbal supplements like ginko biloba, garlic, ginseng, fish oil, dong quai, feverfew, and tumeric, as well as high potency vitamin E. I advise patients to avoid taking anything they don't absolutely need to treat a medical condition if bruising is a concern.
Patients should not rub the injection site areas for several hours after the procedure and should avoid laying down or otherwise positioning themselves where the product could potentially diffuse into an unwanted area (low risk but possible). Patients should avoid strenuous exercise for the day following injections to decrease the risk of bruising (due to elevated blood pressure).
Patients are free to return to normal activities 12 hours following injection or the following morning.