Clexane dose for long haul flights

[juanacalpe]

Hi can anyone give advice on dosage of Clexane for long haul flights? I know i was advised to inject for 3 days b4 outbound flight, day of the flight & 3 days after - then the same for the return, but can't remember the dosage

[daisyd]

Hi you should check with your Doctor

Have a lovely holiday

[juanacalpe in reply to daisyd]

Tx

[KellyInTexas Administrator]

Hello juanacalpe,

The three days prior and three days post flight does not ring true to my understanding of the mechanics of Clexane, but you would need to ask your doctor.

Clexane is a, “fast it/ fast out” thinning agent.

At a high intensity mg / kg dosing it would leave your system in 12 hours. The 1/2 life is negligible, and dose dependent. If falls off very fast- this is why it must be administered every 12 hours on the dot at 1mg per kg of body weight.

So you see, there is no therapeutic advantage to dosing three days ahead of flight, or after flight. There could only be risk, especially if you are already on other anticoagulation or anti platelet therapy.

Unless I am unaware of a mechanic of action a doctor has not informed me of, I think this information is incorrect. You would need to inject just as the plane is about to take off.

You will need a letter explaining your condition, and your heparin needs to be with you in the cabin of plane . ( heparin is sunlight and temperature sensitive, as it is a protein and degrades rapidly.)

[juanacalpe in reply to KellyInTexas]

Thanks Kelly - thats definitely how its been prescribed the last few times ive flown long haul. Will go back to docs 😀

[KellyInTexas Administrator in reply to juanacalpe]

There may be a reason I’m completely unaware of, and should learn about. Please let me know so I can ask my ( new) Hematologist.

I may well have a gap in my knowledge. ( and it may have to do with “ lag time” . )

[juanacalpe in reply to KellyInTexas]

Will do 😀

[MaryF Administrator]

HI this needs to be prescribed by your doctor and also it is advisable to have a spare shot for each flight in case you take it and then your flight is delayed. As this does not stay in the system long, if I ever go long haul I have been advised this will be the case, but I do have a very good GP. The dosing will be decided by your individual Hughes Syndrome/APS consultant.

[juanacalpe in reply to MaryF]

Thanks Mary - got the precription today 40ml shots -1 day for 2 days before flight, 1 on day of flight and 1 the day after

[KellyInTexas Administrator in reply to juanacalpe]

Can you please explain the reason why it’s prescribed this way, please? This is unfamiliar to me and I’d like to learn the reasoning behind it. ( are you on warfarin currently?)

[juanacalpe in reply to KellyInTexas]

Hi Kelly - i dont know,why & didnt ask my busy GP to explain. I'm not on warfarin -,just low dose aspirin

[KellyInTexas Administrator in reply to juanacalpe]

I totally understand... I think the answer is because you are on aspirin . I’ll check with my heme. ( I also have a very good one- I’ve just not asked him about long haul flights.)

[HollyHeski Administrator in reply to KellyInTexas]

Kelly, not done a long haul flight for a while, but when I last did, I was advised to not fly more than 10 hours in 24 hours (so when we went to Australia, broke the journey up over several days), also advised and prescribed extra 40ml clexane, to take just before any flight over 4 hours and to continue normal daily prescriptions, (clexane, aspirin and clopidogrel) as normal.

We've just lost some family members and one of our dogs, which has stopped us flying for a few years but now hoping to start travelling again, so will get an updated view of what's needed to be prescribed from my specialist soon.