Any tips for taking regular medication when changing time zones?

[Coco51]

I'm off to the the USA in a couple of weeks. I take (among other things) Apixaban Flecainide which are supposed to be at regular - ish 12 hour intervals. 8am and 8pm work best for me.

I'm wondering how to adjust, or if it really matters? I will check with the GP - if I can see them - or a pharmacist, but does anyone have any tips?

There's a five hour time difference. So if I take it at 8am Uk time the day I fly, 12 hours later will be 3pm East Coast Time.

Could I leave taking the medication til 8pm - a 17 hour gap - and continue at 8am and 8pm as usual. Or should I try and adjust it by moving forward 1 hour every day? (Which will mean 4pm then 4am, then 5pm and 5am...etc etc).

I'm a bit stressed about going and this is making my head spin!

[BobD Volunteer]

Either is fine, whatever you want to do. It really is not that critical as the residual effect lasts long enough.

[Coco51 in reply to BobD]

Thanks Bob. I feel reassured by that.

[stagecoach]

I travel to the east coast USA frequently and I also take Apixaban (but not Flecainide any more). I usually take this at 8am/8pm but on the day of travel I take at 8am and then at 6pm in the US. The following morning I take at 6am, then at 8pm then 8am/8pm as usual for the rest of the visit. Can't help with the flec..

[Coco51 in reply to stagecoach]

Nice to hear that. Sounds like a good plan. I was thinking of similar. What do you do coming home?

[stagecoach in reply to Coco51]

I take the evening dose at 7pm (12 midnight UK). The following morning I take the dose at 11am UK (ie 1 hour early) and the evening dose at 9pm. following days usual 8am/8pmI used to try and adjust gently but found the above to be easier to remeber and manage.

I also use a pill remider app to help manage my medication.

Have a good trip.

[Coco51 in reply to stagecoach]

That makes sense. Thank you.

[CDreamer]

What I used to do is to start to adjust the time I took my meds by a few hours a few days before I flew - my only proviso would be to stick to a planned regime as it’s very easy when travelling and changing time zones to forget and either not take your meds or take double dose because with Jet Lag you can’t remember so rule of thumb - remember that it’s better to miss a dose than take a double dose.

Have a great trip.

[Coco51 in reply to CDreamer]

That was what was worrying me! Starting before you leave is a great idea. The return journey is obviously where the o/ d is more of a problem.

Last time I went to America I was footloose and tablet free... Wonderful! Now I also have Covid to worry about. Never good but especially bad on holiday. But it's been planned so long round a family event that I feel I have to go!

[Outtheresinger]

I faced the same conundrum when I travelled to New Zealand a couple of years ago. I asked my pharmacist who told me he had never been asked this question! Why aren’t there any recommendations for this problem? I had a night flight so I took my evening tablets at my normal time then took my morning ones 12 hours later then took my morning ones at my normal time in NZ. Enjoy your trip!

[Coco51 in reply to Outtheresinger]

That worked well. I guess a lot of people don't think too much about It? Was the pharmacist any help at all?

[Singwell]

I'd adjust by 2 hours at a time. You can also start the day before leaving. 5 hours isn't too much and each of these meds also has a 'half life' of a number of hours, which means they're still effective. If you sometimes need extra Flecainide keep it handy. One tip from my recent trip - walk around once an hour- up and down the gangway. I started getting uncomfortable ectopics so I marched up and down a bit. Seemed to help.

[Coco51 in reply to Singwell]

After all these tips I was thinking of starting before I leave. And you are right a couple of hours is not too much. I am over thinking it a bit.

[Singwell in reply to Coco51]

I did the same. Is it your first International trip since developing AF?

[Coco51 in reply to Singwell]

I have been to Europe 3 times a year since having AF but not to the States. Last time there was 20 years ago!

[Tellingfibs]

I take Warfarin ( plus other drugs ) and I was very worried about the time zone difference when I went to America, because Warfarin should be taken at regular intervals. Because I stress over all things related to counting, I decided my best option was to keep my watch set on UK time, so regardless of what time it was in the US, I could see what time it was at home just by glancing at my wrist. This worked superbly and there was never any need for calculations. Mind you, that’s my drugs and they don’t have to be taken at specific times of the day for them to work, just at regular intervals. This strategy worked for me heading westwards as I ended up taking my pills at about lunchtime instead of evening, but travelling eastwards, changing a time zone more than 5 hours ahead, would have meant I was taking my pills around midnight and that’s a bit late for me. Anyway, it worked for my US trip !

[Coco51 in reply to Tellingfibs]

Yes i was on Warfarin a while back. But it was once a day. Apixaban should be taken12 hours apart. I don't fancy waking at 3am to take the first dose of the day! But knowing me and jet lag I'll be awake by then anyway! it's actually rather a good ruse to keep the watch on UK time though. Thank you.

[Eastwick]

I travel regularly to the USA and don’t worry about it! Have done it for years now and just take it at my usual time in America even if there has been a 5 hour difference. Never had a problem

[Coco51 in reply to Eastwick]

I did think of that. Then you have the 5 hour gap and it's all over and done with and no more to think about! Then just miss a dose when you come home I guess.

[belindalore in reply to Coco51]

You'll figure it out. And be fine. Just have a good safe trip.

[belindalore]

I would say adjust dose in the time zone you will be in the USA. Whatever time it is in that time zone that corresponds to the time where you live. If you take it at 8 at home find out what time that would be in the USA. That sounds more complicated than it is. But it looks like you have gotten pretty good advice.

[Coco51 in reply to belindalore]

Yes it's all been good advice, and thank you for your reply😊

[belindalore in reply to Coco51]

Not sure it made any sense after I wrote it. 😱 Buy you are welcome.

[Coco51 in reply to belindalore]

It's fine! 8pm is 3pm in USAEast Coast but then I need to take the next one at 3am...not brilliant, though with jet lag I will be awake.

But I have stopped worrying now. All the tablet boxes say if you forget a dose , take it when you remember, but not too close to the next dose. So I can leave it till 6am or even 8am then continue as usual on US clock.

Would like a full dose of anticoagulants during and after the flight however.