PI-WIKI-PHARM-32 · Pharmacology · reviewed 2026-10-31
Pharmacology, Systemic Medication and Body Art
Critical numbers
Isotretinoin wait, after treatment ends6-12 months
DOAC half-life (apixaban, rivaroxaban, dabigatran)~5-17 hours (dabigatran longest)
Warfarin, minor cutaneous procedureContinue
Clopidogrel after cardiac stentNever stop without cardiology approval
Biologic therapyDo not interrupt
MethotrexateSpecialist clearance
Opioids, acute high doseDecline the session
Client-applied numbing cream with epinephrineAvoid
Alcohol before a session24-48 hours
Aspirin, platelet function recovery7-10 days
Clopidogrel, offset before a procedure5-7 days
Lidocaine, maximum single dose (adult)4.5 mg/kg plain, 7 mg/kg with adrenaline
Do not
- Telling a client to skip a dose. It comes from a good place and it is the most…
- Asking about conditions instead of drugs. A tick box marked "any medical…
- Treating supplements as harmless. The client on warfarin who also takes garlic…
- Refusing anticoagulated clients outright. The dermatologic evidence does not…
- Accepting a verbal "my doctor says it's fine". Where the risk is real
- Treating chronic prescribed opioids as equivalent to acute intoxication. They…
Applicable standards
- European Union & UK — Directive 2001/83/EC (as amended)
- United States — FDA iPLEDGE REMS (isotretinoin)
- ASEAN & Asia-Pacific — Australia, Poisons Standard (SUSMP)