Alcohol versus Warfarin

[Isis]

I need some input on how much alcohol affects "your" INR.

I just got my Coaguchek XS today and since I like to have a margarita or two every now and again I'm am ready to start some INR response to alcohol testing; ........just for medicinal purposes mine you

So, my questions are:
1) How much does your INR increase after having one drink, two drinks, etc.
2) How long after drinking does your INR reach its maximum level.

Thanks,

 

[briansmom]

As I understand it, it has no effect on your INR. Alcohol can be very hard on your stomach, so if you have an ulcer or anything of that type you could bleed. The other risk is that your balance and judgement can be impaired when you drink alcohol - that is not so good when you are anti-coagulated. So, IMHO as long as you don't over do it, then you can certainly enjoy your occasional margarita.

 

[Cooker]

"one or two, now and then"........no problem........of course it might....depending on the size of the glass

 

[sue943]

One or two is not a problem, binge drinking is a problem.

 

[Karlynn]

It affects your INR to the point that you have so much you get dehydrated and sick and the Coumadin level in your system is more concentrated because of it and your INR goes up.

So - don't get plastered.

The other issue is bleeding ulcers - if you have them, you shouldn't be drinking anyway, but if you're on Coumadin and drinking it will cause you to bleed sooner.

Many of us enjoy adult beverages in moderation without worry. A margarita or two every now and then isn't going to be a big deal. 7 on one night will cause your INR to raise quite a bit and cause you to want to cut off your head with a dull butter knife. This is my finding after my serious study on the subject last New Year's Eve.

 

[Bina]

Isis, congratulations on getting your new machine....freedom is nice.
But I wouldn't be using it to regulate drinking effects on INR. That could be dangerous.
If you make a rule out of never exceeding 2 drinks on any 1-2 day period you should be fine.

 

[Philip B]

Testing

Testing

Hi Isis,

This week, after testing my INR on Thursday morning I attended a party on Thursday evening. While at the party, I drank three glasses of wine. I re-tested my INR on Friday morning to see if a significant change had occurred. My INR was up .2.

.2 is not a significant jump, but I doubt I'll exceed a two or three glass limit at future events. All things in moderation is in my opinion not bad advice.

Like many things associated with AVR surgery and the post-op meds we take, I suspect how much alcohol it takes to significantly affect INR is an individual thing.

-Philip

 

[Magic8Ball]

This is one of those subjects where i have found its really hard to get a straight answer from anyone or an honest admission/opinion.

I was the same as you, wanting to know what i could safely drink but could not get any real feedback so here's mine for you.

I realised there would be no more dancing in the street, slured voice, crawling along the floor and throwing up in the toilet sessions but i just wanted to know how much is ok to drink in moderation.

So to give an honest answer i will usually drink a couple of glasses of wine every other day if i feel like it. If not wine i will have a couple of bottles of lite beer. I don't drink on a daily basis but i may drink for three days in a row and then not for two, its just a 'when i feel like it thing'.

My favorite drink pre surgery was vodka but i don't touch the stuff now...i realised i drank it for affect and not for enjoyment...i really rarely touch the spirits although in the past year i would say i've probably had 5 small (measured) burbon & cokes...only one at a time.

On a 'party' night when everyone is drinking i will actually drink 4 glasses of wine (a whole bottle) or what i would tally up as the equivalent intake of alcohol in lite or normal beer.

I have tested my INR before/after with my home tester in the early stages of my drinking and went from 2 glasses to 3 to 4 with lots of testing before and after, no change was found.

The first jump to 4 glasses (from 2) was accidental....i thought i'd had two glasses of normal wine and two glasses of acholol free wine but later found out i'd opened the wrong bottle....a little panic and an inr test the day after calmed my nerves.

I have on 2 very rare occasions had 5 glasses of wine with no affect.

I have also been on a business trip where i have drank four glasses of wine a night for six consecutive nights with no affect on my INR. I tested 3 times during that week as i knew it would occur and did not just decide on the spur of the moment to do this.

I have no desire to push the envelope any further, four glasses of wine enough for me to 'taste', after four glasses i'm as sober as a judge and still way legal to drive (ive tested on a police class tester). The only reason to drink more is to try to get 'drunk' and i know that will never happen in an acceptable amount of 'addional' glasses so i just don't see the point. As i said i only ever wanted to be able to sit and have a couple of glasses of wine with friends at a party and not feel odd by sitting with a soft drink or a cup of tea.

Also to qualify the above, i am 6ft4ins tall, male and about 18.5stone (118kilos).

If you are a 5ft2ins 7stone woman i'd guess your tolerance levels will be different.

So from what i have picked up from the snippets around various posts is that alcohol has no affect on your inr BUT dehydration does....an excess intake of alcohol leads to dehydration. If you ever were drunk and on warafin any fall you have has much more danger associated with it. If you drink and have stomach ulsers its not clever as you will suffer from bleeding. Excess drinking affects the organs that help warafin keep us alive so its not a good idea to abuse those organs with alcohol and then expect them to keep us alive for another 30 years processing warafin.

And another qualification...i have no medical background nor an overly informed knowledge of this subject area....it's just a frank admission of what i've done and found acceptable to me so that you can take the info aboard to help with your decision making.

I hope this helps you find your balance...

 

[Karlynn]

With the exception of ulcers and other gastronomical issues that result in bleeding do to anyone drinking alcohol, I think the rule of thumb is the more drunk you get, the more it will effect your INR - due to the dehydration.

For me, it's fortunate that both go hand in hand - because I can't stand the morning afters. (or the evening-of as the case may be sometimes.) So I'm a moderate to light drinker. I love my Diet Coke w/ Lime and Captain Morgan's spiced rum. I go through periods of having one in an evening 3 or 4 times a week, just for the enjoyment and I've never had an INR issue. If out with friends I'll have 2, but don't go beyond that because of the "afters" (I'm a light-weight), it's just a plus that it's also better for my INR. I used to have a glass of red nightly for years until I became sensitive to the sulfides and get horrible headaches now.

After last New Years and my Cosmo Catastrophe, my INR was over 7 for a day. I got it back in range w/in 2 days by holding a dose and then taking half a dose. I will not be repeating this New Years (although I had such fun!), more because I felt like the floor of a men's public restroom than the INR issue. But I was fortunate nothing happened due to the INR. I even tripped and fell while walking my dog (a hard 4 point landing) and my bruising was no worse than normal. However, the horrible hangover was a good reminder that it's not good for my INR. I'm positive the high INR was due to dehydration from the large amount of alcohol and then getting sick. (I literally didn't get out of bed until 7 pm New Years day.) I figure after 16 years of Coumadin use, I was due for a Stupid Award.

 

[Bina]

Karlynn, your story is a good reminder since New Years Eve is a couple of weeks away.
Toilet Huggers take note!!!

 

[Cooker]

Karlynn, your story is a good reminder since New Years Eve is a couple of weeks away.
Toilet Huggers take note!!!

I was one of those that was blessed or cursed with the fact that I never got hangovers Life without alcohol suits the chimp just fine and just one less thing I have to worry about

 

[Elcarim]

I had a big weekend at a festival earlier in the year, drank more than I would normally drink in a few months, probably about 12 drinks over the weekend. I didn't get especially drunk, but it was over a prolonged period.

I had an INR check the next day... my INR was normal.

Two things have been found to affect my INR - fluctuations in my body weight and taking antibiotics. I was on Keflex for three days and my INR went from 3 to 3.9.

 

[Ross]

Not all antibiotics affect INR, Keflex without doubt is one that does.

 

[Isis]

Thanks for the responses everyone.

Good to know that a few drinks probably will nt affect INR. I usually don't drink more than 2 or 3 drinks at a time so I probably will be ok with that. I'll do an INR test the day after I have a few just to verify. I've been stable at 2.8 for the last month; tested 2.8 a month ago at the lab and 2.8 twice since than with my new home machine.

Best wishes,

 

[DiscoG4]

Drinking & Warfarin

Drinking & Warfarin

Isis,

This is a really interesting topic, being ex military and an ex pilot, oh and British, boozy pub sessions are a bit of a way of life for me! I realized that the valve replacement was going to crimp my drinking style a wee bit and like you sought some advice.

The major problem I found is that the advice is both varied and in some cases contradictory, for instance, the surgeon advised drinking a couple of glasses of wine or beer on a regular basis, my GP agreed with this on the basis it would 'normalize' a dosage of warfarin. However the girl at the anti-coagulation clinic warned me that I should restrict myself to half a pint otherwise I might spontaneously melt or something! The consensus appears to be to avoid binge drinking. However there is a disagreement I believe over the way warfarin is metabolized in the liver and whether the liver would break down alcohol over warfarin, which could result in lower INR's, but whether this accurate or not is hard to say because health professionals have differing views.

To be honest, I've had a couple of heavy sessions since my op with no discernable increase in my INR (when tested 24 / 48 hours later) and I regularly drink as I love real British beer! I also love scotch but don't drink it very much as ever since the op it gives me heartburn! I wouldn't advocate heavy drinking and the couple of times I overdid things I regretted it, the worry factor of whether you're going to bleed from your ears plus the hangover make it not quite the fun it used to be! Also drinking too much increases your blood pressure which in turn puts pressure on the heart structure and the valve implant, the surgery team were very keen that blood pressure was kept low after valve replacement, so this is something worth considering.

Don't forget everyone's metabolism is different, some people might get away with hitting the bottle without any problems others may have more of an adverse reaction I guess this is why the doctors err on the side of caution. I've also been told that the risk appears to increase as you get older, don't know if anyone else has heard this?

Still it's nearly New Year and what would life be without a couple of glasses of Dom P!!

All the best

Steve

 

[ClickerTicker]

Steve, hmmm, yes...
Functions at the Golf Club can get a bit boozy - my wife normally (well almost always) drives home.
They always have three excellent beers on tap and a good wine list.
Although I certainly don't do it on a regular basis - it's not unknown for a couple of pints and a bottle of wine to have slipped down by the end of the evening.
Even with that I've never noticed an effect on my INR, but then I do have a pint of London Pride or similar and a glass of wine most evenings.