How do you deal with taking Sintrom (euro drug instead of UK Warfarin) when changing time zones eg UK to Bangkok then to Australia?

[HardyLA]

[Tipper]

We did a trip early this year from UK to Dubai to Brisbane to NZ, for two months, and then back to UK via Sydney. My INR never went out of range.

I self manage using a Coaguchek XS and had no problems at all and can highly recommend DIY testing and dosing. It's not rocket science as can be seen by the number of times my GP got it wrong before I started DIY! Weekly testing is far better than the monthly/6 weekly testing carried out by the 'professionals' who, after all, aren't living the condition!

As to dosing times which is the main issue I was more concerned with other regular 12 hour drugs than Warfarin which takes 2-3 days to take effect and alter INR. Those drugs I flexed a couple of hours a day until I was back in time. All went well as my wife will verify!

[HardyLA in reply to Tipper]

Thanks. Our Spanish doctor today suggests 8hr flights are too high risk for my husband. It was a pulmonary embolism that caused the need to use SinTrom (like Warfarin) and she says flights over a couple of hours may cause further damage to the lungs. So getting a little worried now about whether we should go or not.

[woodge]

We are just back from a trip to Ct USA, I also flexed a few hours getting there and on return, also on return we had daylight saving, so my timing was not quite right. I am still here to tell the tale! Also take enough pills for emergencies, we were involved with the hurricane, and flights etc cancelled for a week. No power, shops closed and flooded. I returned with only two pills left. I do not self test so if results were not good I was not aware, felt OK. I take warfarin and omperazole.

[Impatiens]

I have done BKK to Oz a couple of times but on warfarin not the drug you take - 5 hours in Thailand ahead so take 2.5 hours later than normal the first day then on time the next and so on. Enjoy and worry not I have traveled extensively and just get on with it. The heat will probably affect your INR so get tested - as I say enjoy your trip

[Donnac70]

Hi, I take my warfarin dose every day at 6pm. This regular time helps to keep my INR in range (I'm a self tester). When I go on holiday I still take my warfarin on UK time. I find this keeps my INR levels stable and I don't have to readjust my dose times when I return home. I went to Mexico this year and they are 6 hours behind the UK. I took my warfarin at 12 midday whilst there. When I came home, I went forward 6 hours and back to my normal 6pm dose time. No daily adjustments are needed to get back to normal.

[Hidden]

Hi, I'm just back from my first long haul flights since open heart. I self monitor and dose. Normally I'm very stable at the target INR of 3, in a 2.5 - 3.5 range. Coming up to the travel I eased myself up to 3.5 to minimize probability of clotting. In my case this is particularly important as I've been fitted with a mechanical aortic valve which has a higher risk of promoting a clot on their mechanism. I decided to stick to my time of day for taking the tabs and to pro-rate the drug dosage appropriately to compensate for time zone changes. After 15hrs of flying I was astonished to find my INR fallen to 2.1. I was even more astonished that when I increased the dose to bring me back on target the INR continued to fall, reaching 1.9. Despite being very comfortable self dosing this was a panic inducing outcome. However I stuck with my plan and the INR began to climb settling at 3. I'm back home 2 days and am going through a similar experience. This time I'm being a little more aggressive in bringing my INR back on target. I agree with Tipper, thank goodness for the Coaguchek I wouldn't be without it.