Advice from frequent flyers please

[PALady]

I'm booked to travel soon and keeping fingers tightly crossed that all will be well. Have made sure I am insured (AF declared) and am taking spare meds and a copy of prescription notes/INR test records. The trip westwards will result in a 4 or 5 hour time difference for a period of 16 days. I'd welcome tips on how to re-time when I take medication. I can take the bedtime meds (Simvastatin and warfarin) at round about same time if I keep a watch on UK time and work to that, but wondering how to deal with the morning ones that I usually take around 7.30 am (Ramipril and Atenolol) without having to set the alarm for some ungodly hour. I'm sure some regular travellers among forum members will have got this worked out, so please share any tips. Thanks

[rosyG]

what about changing times gradually in the days before you go away so it fits in with new timings and then do same on way back?

[Beancounter Volunteer]

Hi PALady

I fly to the far east fairly often, and I would offer a few tips.

1) Separate your drugs into two, one in the carry on baggage and one in the hold, that way if either is lost you have time to sort it out. Take at least twice as much as your need ideally.

2) Go to your pharmacist for a copy of your last prescription, they are pretty helpful and copy it, also one in your carry on and one in your hold baggage.

3) Timings personally I am usually 8 or 9 hours difference, so I move by an hour a day usually two days before I leave and then again two days before I come back. It's never perfect and I suspect the warfarin is the most time sensistive of your drugs,

4) Tell your doctor before you go

5) Especially with warfarin try not to change your diet too much, almost impossible for me in Asia which is one of the reasons I chose a NOAC

6) just research on your destination for INR testing, probably not necessary, but good to know.

Lastly relax, enjoy and forget about your AF.

Be well

Ian

[PALady in reply to Beancounter]

Thanks. All useful. Getting INR test done day before we go, then I have already checked that I could get an INR test done on board cruise ship in the event that Norovirus or something similar strikes us and my lovely nurse at the GP surgery has provided an email address I can send result to, so that she can let me know if I need to change my warfarin dose. Always take 2 sets of drugs with me. Think I will get my next prescription early, just to be sure.

[Hidden]

My normal regime is Apixaban & Diltiazem at 0800 and Apixaban 2000. Four days before going to the States, (5 hrs difference) I pushed the doses forward an hour each day making the last dose in the UK at midnight. It seemed to work for me......have a great holiday.....

[Emsysy]

RosyG has the right answer. It's not that critical to keep your existing home time regime. At least, it hasn't affected me adversely on several far flung trips.

[Hidden]

Hi PALady,

I fly UK to Sydney and don't bother about timings. Do pretty much as Beancounter says. As far as my Warfarin is concerned I leave my watch on GMT and when I get to Sydney change it to local time then resume my meds doses - including warfarin.

To be honest my personal and non medical view is its no worse than going out partying and coming home, crashing out into bed and forgetting to take your evening meds. That is, when you wake up next day you don't play catch ups and take your missed dose with breakfast and then your evening dose that evening. Just write off the dose you missed and carry on at the usual time.

Besides I've twice had to stop warfarin, once for a CT Scan with no bridging anticoagulant after wards and more seriously when I had a partial knee replacement and had to stop warfarin - on both occasions I had to stop for a week beforehand. I was given a bridging anticoagulant after knee job.

A fer instance. I normally leave Heathrow early evening - at that point either on the ground before boarding or in the air, just after take off - I take my evening meds, usually at home this would be around 8 pm. I'm around 10 to 12 hours flight time to Hong Kong, change planes ( could be as little as 90 mins on the ground in HK or as much as 5 hours) and then another 7 hours to Sydney.

Getting into Sydney either early morning or in the evening. If you arrive early morning I just wait till 8pm Sydney time and resume my meds. If I arrive in Sydney in the evening take them straight away. The reverse coming home.

Maybe with me its all in the mind, so to speak, after stopping warfarin twice and for a week each time and being unprotected in that week, a 21 hour flight to Sydney is nothing.

John

[PALady in reply to Hidden]

Ah yes, partying. I seem to remember I used to do that a long time ago, before the AF and then the warfarin came into my life. Happy days. May not party much these days, but don't suffer from hangovers either, which is a blessing.

Thanks to all who responded