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Thread: How long for alcohol to affect INR?

  1. #1
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    Default How long for alcohol to affect INR?

    I am planning on going to the local winery tomorrow. I know there is a lot of discussion/disagreement about whether alcohol affects the INR or how (increase or decrease). My question is this--if the wine does affect my INR, how long will it take? I know a change in warfarin takes about 3 days to affect the INR. Would the alcohol effect be immediate or would it take some days? I have done a lot of reading and can't find anything on this subject (how long it would take). I am having my INR checked on Tuesday. Thanks for any input you may have. Mary
    Modified Bentall aortic root replacement with a
    number 23 St. Jude valve conduit
    Replacement of ascending aorta with a
    number 28 Hemashield graft using right axillary cannulation
    Dr. Richard Mellitt, Boone Hospital Center, Columbia, MO, May 3, 2010

  2. #2
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    Go and enjoy yourself ... as long as you don't go ape ship crazy you should not have any problems...
    No shoes, no shirt, no problem
    AVR with Ablation -St Jude Mechanical--2006
    ~Easy Does It~

    The early bird get the worm but the second mouse gets the cheese

  3. #3
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    as the saying goes "everything in moderation"

  4. #4
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    Thanks. We intend to share at least one bottle over lunch and an afternoon of live music--we may go crazy and share a second bottle.
    Modified Bentall aortic root replacement with a
    number 23 St. Jude valve conduit
    Replacement of ascending aorta with a
    number 28 Hemashield graft using right axillary cannulation
    Dr. Richard Mellitt, Boone Hospital Center, Columbia, MO, May 3, 2010

  5. #5
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    To be honest, I probably wouldn't give it a second thought.
    Cris

    I believe in small miracles.
    St. Jude Mitral Valve 5/16/05

  6. #6
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    Some people here have reported their INR raises if they drink and some report it lowers. Others no change........

    It is impossible to predict how your body will react but were it me, I'd go and have a good time. I took coumadin briefly after tissue valve replacement and all my doctors approved a glass or two of wine. None had any issue with moderate enjoyment of wine.

  7. #7
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    Quote Originally Posted by Cooker View Post
    Go and enjoy yourself ... as long as you don't go ape ship crazy you should not have any problems...
    I second that commotion......uh, motion
    Happy Trails,

    BAV-1999 - St. Jude Silzone recalled valve still clickin'
    CoaguChek testing since 1999
    CoaguChek S testing since 2002
    CoaguChek XS testing since 2009
    "Gee, ain't it funny how time jus' slips away..."

  8. #8
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    I've just come back from a great afternoon at the winery. We had a great lunch, live music and we shared just 1 bottle of wine. I had about 2 1/2 glasses. I have my INR checked Tues and will get INR results on Wed am. I will let you know if my INR is out of wack. Thanks again. It really is so comforting to know that I have all of you out there to answer questions, etc. Hopefully, one day I will have enough time and experience behind me that I will be able to help. Mary
    Modified Bentall aortic root replacement with a
    number 23 St. Jude valve conduit
    Replacement of ascending aorta with a
    number 28 Hemashield graft using right axillary cannulation
    Dr. Richard Mellitt, Boone Hospital Center, Columbia, MO, May 3, 2010

  9. #9
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    Default Alcohol?

    Monitor, monitor, monitor...

    As others have indicated, it varies among individuals. I did some drinking at a family wedding on Saturday. I'll probably run an extra check on my INR on Monday just to see where I'm at.

    -Philip

  10. #10
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    I'm not self-testing yet--wish I were. I've spent several weeks with Roche and my ins company going thru hoops. I think they will pay but I just haven't gone thru enough hoops yet. So I'm still at the mercy of the lab and the coumadin clinic.
    Modified Bentall aortic root replacement with a
    number 23 St. Jude valve conduit
    Replacement of ascending aorta with a
    number 28 Hemashield graft using right axillary cannulation
    Dr. Richard Mellitt, Boone Hospital Center, Columbia, MO, May 3, 2010

  11. #11
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    FYI I got my INR results today (from lab work yesterday). After going to the winery on Sunday--my INR is exactly what it was 2 weeks ago--3.1. So my 2-3 glasses of wine had no effect on the INR.
    Modified Bentall aortic root replacement with a
    number 23 St. Jude valve conduit
    Replacement of ascending aorta with a
    number 28 Hemashield graft using right axillary cannulation
    Dr. Richard Mellitt, Boone Hospital Center, Columbia, MO, May 3, 2010

  12. #12
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    Thanks for letting us know. How good you now have an idea how your body will process that quanity wine and can relax and enjoy in the future.

  13. #13
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    Go get blasted !!!.

    Brigham and Women Hopsital -Dr.Shekar OHS- June 1,09
    AVR-St.Jude Mechanical Valve. (25VAVGJ-515)
    Ascending/Transverse Arch Aortic Replacement


    Nelson

  14. #14
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    Keep in mind that it takes 24 hours for alcohol to get absorb into ones system.
    To have gotten an actuate reading if the wine had affected your INR you should have tested Monday morning. (I know Monday was a holiday)

    Getting test results a day later is really unacceptable. I'm not going to get into this as there are other threads on this topic.
    Laughter is the Best Medicine

    MVR March 30/07 Carbomedics Valve - Said and done in 5 days - Shocked & Dumbfounded
    I've learned..That to ignore the facts does not change the facts

  15. #15
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    I know. I can't wait until I start home testing. I would really like to do self dosing as well, but my cardiologist doesn't do that. We'll see.
    Modified Bentall aortic root replacement with a
    number 23 St. Jude valve conduit
    Replacement of ascending aorta with a
    number 28 Hemashield graft using right axillary cannulation
    Dr. Richard Mellitt, Boone Hospital Center, Columbia, MO, May 3, 2010

  16. #16
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    I haven't done my alcohol/INR study yet (but will be soon now that I have a home testing kit). But all indications (from my INR readings at the dr. office after drinking a couple days before) are that it doesn't affect my INR much, if at all.
    - Andy
    Born with BAV; Moderate/Severe Stenosis/Regurgitation by age 49; AVR Surgery 5/5/10 by Dr. Robert Emery, St. Josephs Hospital, St. Paul, MN; St. Jude Regent Mechanical Valve

  17. #17
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    Personally, I have doubts that Alcohol has ANYTHING to do with the Vitamin K/Vitamin K Agonist process that makes Warfarin useful as an anticoagulant.
    Until I had an epiphany a few minutes ago, after reading other postings about 'drink today' 'test in three days', I joked about sharing a bottle of wine and having my dosage set for that alcohol input -- and having to keep drinking so my INR is stable.

    Now, I'm thinking that this kind of thinking about alcohol is wrong.

    Alcohol is quickly absorbed by the stomach and enters the bloodstream within minutes of drinking it. Your brain feels the effects very quickly. If it's in your blood, I suspect that the effects on clotting will be almost as rapid.

    There are many drugs that can impact your clotting much more rapidly than Warfarin (think Heparin or Lovenox, for example), and if Alcohol has an effect on your INR, I'm assuming that it does so in a non-warfarin-like way. The effects on INR are probably much more immediate, and probably somewhat temporary.

    I'm thinking that, if someone really wanted to see what kind of effect alcohol has on INR--and they had a meter and a dozen or more test strips they don't mind burning through, they would do a test like this:

    Before taking that first drink, test your INR.
    In the middle of that bottle, or when you're partway through with your drinks, or whatever, take another test.
    When you're finished drinking, test again.
    Then, test again every 30-60 minutes for the next hour or two (or three),
    Finally, I'm thinking, test at 3, 6, 9, 12 hours. If there's a consistent difference from your pre-alcohol tests, continue until your INR is back within .1 or .2 of your pre-drinking values. I suspect that if there ARE any differences as a result of alcohol consumption, that the difference will spike fairly rapidly, then taper down gradually until they reach your pre-test INR.

    Be careful, too, not to confuse the results by taking other things that may also have more rapid effects on INR during that time (no aspirin, which would be a pretty dumb thing to take before drinking, anyway, because you don't want stomach bleeding, for example).

    ----

    Testing for results of alcohol on INR after the alcohol is completely out of your system probably would show NO CHANGE.

    ---

    Is anyone up for this testing routine? Can anyone afford to burn through 6-12 strips in one day?

  18. #18
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    Alcohol itself is an anticoagulant.
    It also has a dehydrating effect on the body, which can raise INR.
    Undoubtedly your test idea would be interesting, similar to the tests the police do from time to time to illustrate the impact of drinking on one's blood alcohol level and ability to do simple tasks.
    Absolutely once the alcohol is out of your system in a day or two, the effect on INR is past.

    But it's also a case of raising the INR combined with the natural anticoagulation properties of alcohol. Just like using aspirin with warfarin, or with alcohol, there's a cumulative effect. And it may not all show up in the INR. For instance, right now I've been on both warfarin and lovenox post surgery, trying to get back in theraputic range. I'm also on baby aspirin. But my INR hovered around 2 for weeks. Today I'm finally theraputic.

    Needless to say, I'm not adding alcohol to this mix. I'll be happy tomorrow when my last lovenox shot gets out of my system. Next week I may have an occasional glass of wine. The key is not to over do it.
    Laurie
    MVR & maze & pacemaker-2006
    ICD-2007;
    AVR & tricuspid repair w/ ring 8/11/2010
    home testing since 2006

  19. #19
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    I was a bit concerned about someone actually being ABLE to run a successful test if this person had too much alcohol in the system. (Those strips have really small areas for putting the blood).

    It would be interesting to see how much anticoagulation can be caused by alcohol -- would someone with a 2.5 suddenly wind up with a dangerous 6 after drinking a couple bottles of wine? Would a six pack of beer raise an INR from 3 to 5? In other words, would (or could) a LOT of alcohol over a short period of time actually raise an INR to unsafe levels? (Of course, driving while drunk is an awful idea - but doing so with a dangerously high INR would be even worse).

    I'm not convinced that the effects of drinking would, long term, be cumulative -- except for the fact that too much drinking could possibly damage the liver, and THAT could cause the INR to climb. (Coincidentally, CSI New York last night had a case where a hepatotoxin (liver toxin) damaged the liver and caused the INRs to climb so high that people died of internal bleeding - so I guess cumulative effects of alcohol on the liver MAY eventually raise INR secondary to liver damage).

    I think my test, should anyone want to try it, could help shed light on what the actual effects of alcohol (in somewhat limited amounts, I'm guessing) are, right after drinking and for the next few hours. Can a few drinks raise INR more than a few points?

    I may have some extra strips, but I have enough trouble getting the blood on the CoaguChek PT strips when I'm SOBER, and my supply of ProTime strips is diminishing, so I'm not sure I'll be able to do the test I suggested.

  20. #20
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    I'm still new to all this (4 mos) and still naive about it, I guess. That being said, I really do NOT understand why "the powers that be" don't know EXACTLY how and when alcohol will affect the INR. Alcohol and Warfarin are neither one new and they know how and when a doseage change in Warfarin will affect the INR--so why don't they know more about the effects of alcohol on the INR? Andy, I'm anxiously awaiting your study results. Maybe you can publish them and make some big bucks!
    Modified Bentall aortic root replacement with a
    number 23 St. Jude valve conduit
    Replacement of ascending aorta with a
    number 28 Hemashield graft using right axillary cannulation
    Dr. Richard Mellitt, Boone Hospital Center, Columbia, MO, May 3, 2010

  21. #21
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    For the proposed test to have any validity, a very large number of people must participate and careful measure taken of quantity of alcohol consumed including whether hard liquor or beer/wine. Without a large study, one or three or five person's testing is meaningless IMO as any indication that it raises , lowers or does not change INR.

    There have been enough people here who have said both that their INR is and others who say their INR is not impacted by alcohol. Some have told of being offered beer or wine with their dinner while in the hospital post op. Other coumadin managers told their patients they have to give up drinking.

  22. #22
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    Absolutely no effects here. My cardiologist prescribed one or two glasses of red wine daily which I adhere to.
    Happy Trails,

    BAV-1999 - St. Jude Silzone recalled valve still clickin'
    CoaguChek testing since 1999
    CoaguChek S testing since 2002
    CoaguChek XS testing since 2009
    "Gee, ain't it funny how time jus' slips away..."

  23. #23
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    JKM7's comment about needing better controls for a study are well stated.
    For a good study, the people running the test will probably take pure (as pure as possible) Ethyl Alcohol, measure the exact volume, and mix it with something to make it a bit easier to drink (maybe 50:50 with water, for those who already drink Vodka). They'll probably want a number of test subjects -- although 'anecdotal' reports of only a few subjects may be of some value. They'll have to decide whether or not to use subjects who ARE taking anticoagulants or who are NOT taking anticoagulants (and, if the subjects ARE, there are a lot of other issues -- age, sex, current dosage of anticoagulant being taken, etc.) A good, scientific study could be a long process - and may not be a lot more valuable than doing a test on YOURSELF to see if you, personally, have an issue with alcohol's effects on your INR -- testing shortly after drinking (or even WHILE drinking) may show something, and a test or two, if an effect is seen, in an hour or a few (as long as changes are seen), may help clarify how YOUR body deals with alcohol and INR.

    Even testing yourself may not be a reliable test -- if you drink with food, perhaps the food had some minimal short term effect on INR. The next time you drink, your body may react differently. What should probably be assumed is that the effects of alcohol on your INR are probably short-term; the probably won't show up on a test hours (and certainly not a day or more) later.

    I haven't seen any reports of alcohol making an INR spike or drop dramatically. (If, for example, that bottle of wine -- or, being a bit more dramatic - that bottle of tequila, suddenly changes your INR from 2.5 to 6.5; or drops it from 2.5 to 0.6 - then there should be reasons to be concerned and to avoid alcohol). I don't think this is the case.

    And, possibly because this effect hasn't been observed, researchers probably didn't see much need for spending the money that controlled tests would cost on research that really has little impact on how we live our lives. (And the drug companies couldn't develop a medication that they claim anyone on anticoagulants MUST take when they drink, so that we don't drop dead from a stroke or bleed to death, and charge $10 per placebo)

    And Mecretired -- I don't think anyone gets rich doing this kind of research.

  24. #24
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    I would not count on any such study any time soon.

  25. #25
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    A past member here shared a story of getting very wasted on a holiday and having a huge spike in INR the following day.
    Red wine, in moderation, with a meal is obviously not going to produce those same results.
    BAV-Aortic Stenosis...AVR Oct 11, 2005 / St.Jude Regent mechanical 21mm
    INR Home testing since 2007 with Coaguchek XS...Self-Dosing

    "Caution: I may have been in contact with Nuts"

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