Drinking alcohol on warfarin

[Chuck C]

Any restrictions/limitations with the mechanical valve?

At my four month check up, my cardiologist gave me the green light to go 100% in all physical activities relating to cardio and lifting weights. In fact, just yesterday I climbed to the top of Mount Monserate, 1,500 ft + elevation, with another Valve Forum member who is celebrating his 3 1/2 month recovery point. He has a tissue valve, BTW, but we both did just great. I might post an update on a different thread in the next day or two include information about that.

since my four month appointment, I’ve done some heavy weight lifting flipped the 220 pound tire all around the gym and done pretty hard-core high intensity intervals.

 

[Seeker]

I enjoy chasing my Warfarin pill down with a good glass of Merlot.

 

[ETC908]

At my four month check up, my cardiologist gave me the green light to go 100% in all physical activities relating to cardio and lifting weights. In fact, just yesterday I climbed to the top of Mount Monserate, 1,500 ft + elevation, with another Valve Forum member who is celebrating his 3 1/2 month recovery point. He has a tissue valve, BTW, but we both did just great. I might post an update on a different thread in the next day or two include information about that.

since my four month appointment, I’ve done some heavy weight lifting flipped the 220 pound tire all around the gym and done pretty hard-core high intensity intervals.

This is awesome! Thank you. Very glad to hear that you have been able to amp things up relatively quickly. Hopefully I can follow a similar path!
Thanks again.

 

[pellicle]

This is awesome! Thank you. Very glad to hear that you have been able to amp things up relatively quickly. Hopefully I can follow a similar path!

I'm not sure if you read my posts within this thread but I've mentioned also that I can have a few and have no significant (or even lasting) effect on INR.
Upwards of half a bottle or Shiraz and a whiskey or two ... other thread abound on this topic.

I doubt its because of the quality of Australian booze because I experienced the same in Finland drinking Argentine and South African wines

I see no reason why you can't have a glass of red every night ... heck I do. Its for medicinal reasons of course ;-)

 

[almost_hectic]

So… if the worlds coumadin supply should disappear, how many beers a day will it take to maintain a 2.5 INR? Serious question

 

[MdaPA]

So… if the worlds coumadin supply should disappear, how many beers a day will it take to maintain a 2.5 INR? Serious question

My understanding is that while alcohol does impact blood coagulation (e.g. can increase bleeding risk if drinking too heavily), it alone would not impact INR. i.e. drinking a 12-pack of beer would not change your INR (it would remain 1.0) if you are not on Coumadin, taking other drugs, or have liver problems. It's the interaction of alcohol and Coumadin that could impact INR.

Now, does that mean that those with mechanical valves can use alcohol as anti-thrombotic therapy in the absence of Coumadin (i.e. as a back-up plan), I don't know. Sounds like that would make an interesting study though.

 

[Chuck C]

Now, does that mean that those with mechanical valves can use alcohol as anti-thrombotic therapy in the absence of Coumadin (i.e. as a back-up plan), I don't know. Sounds like that would make an interesting study though

I expect that there would be no shortage of volunteers

 

[almost_hectic]

Well if we run out of Coumadin, I have to try something... so why not

 

[Superman]

Well if we run out of Coumadin, I have to try something... so why not

Either way, if the warfarin is all gone and I have a stroke, having a lot of alcohol might help limit any suffering.

 

[LondonAndy]

Hi ET,

I have not had any issue with alcohol and INR since going on warfarin 7 months ago. In a typical day I will usually have one or two glasses of wine and I almost always stay in range. I self-monitor and I like data and feedback, so I have tested to see affects from various amounts of alcohol. I'm not generally a heavy drinker, but I have had a few days watching the fights where I might drink 5-7 beers. I have noticed that on the morning following that many drinks that my INR does inch up, but not to alarming levels. I might have been consistenly at INR of 2.5 and the morning after having several drinks I might be about 2.8, for example, which would still be in my target range of 2.0-3.0 and then the next day it will be typically back to 2.5.

I have also experimented with dropping my dose just a little, if I believe that I might have several drinks that day- for example from 7mg to 6mg. I have found this to work well for me in keeping my INR from changing due to a day with more than normal alcohol consumption. I'm not suggesting that anyone else do this, but it has worked for me if I want to avoid even a small upward movement of INR.

I think what you want to be careful of is if you don't drink much, then go on vacation and drink heavily for several days in a row. There have been case studies of people who have had problems in doing this type of behavior. This is one of the real benefits of self-testing, because if you were to go on such a vacation and were to drink more than normal for several days, you could work in a couple of INR spot checks during to the trip to make sure that you are staying in range.

I completely agree with this, and have been doing similar since my aortic valve surgery 7 years ago. Thanks to self-testing, doing some extra tests whilst away, I learnt the point you make about extra drinking on holiday, and adjusted my dose accordingly!

 

[Jamey T]

I have done a test on this on the old site, and I found that there was no change for me.
I started sober, then proceeded to have several beers (well over a 6 pack). I tested before I had anything to drink, then I managed to do a test when I was pretty full, and again in the morning when I woke up.

My results worked for me. I am not saying that you can do the same, but it was a fun test.

 

[ClickerTicker]

As has already been said, the golden rule with alcohol whilst on warfarin is the same as anything else diet-related - dose the diet rather than diet the dose. Couple that with the equally important "be consistent" and you won't go far wrong.
In my case I consistently drank at a moderately heavy level since my MVR in 2002. I loved my strong beers, 6% and up were a regular treat, and Malbec red wines.
It never had a particularly noticeable effect on my INR, but that doesn't exempt you from alcohol's more normal effects... my liver started to show signs of distress and I've had to cut back quite a bit to reverse early-stage liver disease.

 

[pellicle]

Clicker

It never had a particularly noticeable effect on my INR, but that doesn't exempt you from alcohol's more normal effects...

I think this is one of the most honest and brave posts I've seen here in a while. For my own information could you tell me a bit more quantitively how much you were drinking? PM me if you prefer.

Myself I tend to have about 1 beer or a whiskey in the afternoon when I've decided to stop working and probably 2 "standard" glasses of wine over the time spanning prep of and eating dinner. I don't anticipate that this is a problem but I do keep an eye on things and make sure that I don't slide down the hill.

 

[ETC908]

As has already been said, the golden rule with alcohol whilst on warfarin is the same as anything else diet-related - dose the diet rather than diet the dose. Couple that with the equally important "be consistent" and you won't go far wrong.
In my case I consistently drank at a moderately heavy level since my MVR in 2002. I loved my strong beers, 6% and up were a regular treat, and Malbec red wines.
It never had a particularly noticeable effect on my INR, but that doesn't exempt you from alcohol's more normal effects... my liver started to show signs of distress and I've had to cut back quite a bit to reverse early-stage liver disease.

This is great, thank you.
I can post this on another thread if that's more appropriate...but speaking of consistency. My diet/routine is fairly consistent. I eat similar stuff all week, don't drink much during the week. On the weekend I indulge with a few drinks. The general consensus here is that it should not have a dramatic impact.
On occasion I may go away for a week or with my wife/kids, during which time we will indulge. Meals out/heavier food, dessert, wine, etc. How dramatically does a week like that throw off one's INR (assuming it's stable heading in), and does a simple dose adjustment usually suffice to correct it? I plan on being diligent with home testing once I'm up and running with it.

 

[pellicle]

... My diet/routine is fairly consistent. I eat similar stuff all week, don't drink much during the week. On the weekend I indulge with a few drinks. The general consensus here is that it should not have a dramatic impact.

agreed

On occasion I may go away for a week or with my wife/kids, during which time we will indulge. Meals out/heavier food, dessert, wine, etc. How dramatically does a week like that throw off one's INR (assuming it's stable heading in), and does a simple dose adjustment usually suffice to correct it? I plan on being diligent with home testing once I'm up and running with it.

you'll need to not only measure it, but do it a few times and measure in the same period afterwards to see if that "result" gets a consistent response. Its like "grandma gave me a cup of Echinacea tea and it cured my cold" single data point " proof ".

I would say that you should just "measure and know thyself".

Its well known that INR is not always stable within an individual and trying to pick why is a fools errand.

Is your INR reasonably in range at the moment? This is my present data set for this year

note time in range is good, the single low event was because I missed a Thurs evening dose and I measure Sat AM ... so it showed up ... duration of the event is low (I took mid week measurements to verify)

note also adjustments in dose on the RHS Y scale

 

[Chuck C]

On the weekend I indulge with a few drinks. The general consensus here is that it should not have a dramatic impact.

As Pellicle indicated, you really need to test and know thyself. It is one thing if a person has 2-3 drinks every day, verses none during the week, then having somewhat of a bender on the weekend.
Personally, I tested my INR after 2 drinks, before I had 3-4 and so on. You may find that you can drink 6 and your INR does not move at all, or you may find that it moves significantly and you need to take a little less warfarin on those days. How much less? Again, this will vary person to person.

Something to be aware of this that, although it is rare, there are some individuals who have a genetic condition which causes their INR to move considerably with a small amount of alcohol.

It is common sense, but you should never drink so much that you risk falling down and hitting your head.

I have a friend who is an EMT. He responds frequently to people to on warfarin who have bleeding events. It is almost always 1) elderly 2) a head injury- usually falling down and hitting their head on something pointy, like the corner of a nightstand 3) when the end result is bad, the vast majority of time he finds that their INR was above their range. BTW, as an EMT it is not routine for them to get reports back with INR reports, as by the time this data is in he has done his job and passed the patient off to the ER, but personally he likes to know and when he inquires they always inform him.

 

[ETC908]

Thank you. I actually haven't even had my surgery yet, but am type A (as I'm sure most here are) and am trying to be as informed and prepared as I can be. I posted on another thread that I was deciding between a Ross procedure and mechanical valve, and for me the main downside to mechanical is the warfarin. So I'm trying to mentally prepare for being on it, and ideally would like to lead as normal a life as I can.
I don't go on benders on the weekend or get fall-down drunk. I have about 2+ drinks on a Friday/Saturday night, admittedly averaging maybe 4 per night. The most I get to is 6, spread out over hours at a time (some may consider that a bender I guess). I might have one drink during the week. Any "excess" drinking that I do is in the confines of my or someone else's home.
I will see how I respond and track things closely, obviously modifying as I go. I appreciate all of the insight. You all are a wealth of help and knowledge.

 

[ClickerTicker]

Clicker

I think this is one of the most honest and brave posts I've seen here in a while. For my own information could you tell me a bit more quantitively how much you were drinking? PM me if you prefer.

Myself I tend to have about 1 beer or a whiskey in the afternoon when I've decided to stop working and probably 2 "standard" glasses of wine over the time spanning prep of and eating dinner. I don't anticipate that this is a problem but I do keep an eye on things and make sure that I don't slide down the hill.

I'd guess my average consumption was around 7 UK alcohol units a day - that's apparently about 4 US "Standard Drinks". I think one my problems was that it was pretty much every day and my liver never had a chance to recover. I'm sure it didn't help that I'd been drinking above the recommended limits for well over 50 years...

First signs were some irregular liver-related blood results found during a routine general test. Then had a Fibroscan test (sort of like a pulsed ultrasound/echo) that measured the level of scarring on the liver and found it was out of range.
It took a year, but by cutting down my alcohol to no more than around 12 units a week (about 7 Standard Drinks) and only drinking at weekends, the Fibroscan readings have come back into normal range. I'm now much more careful and still try to mostly avoid drinking during the week.

As I said in my earlier post, my INR didn't seem to be affected - but that's likely because I was drinking daily and not binging heavily on an irregular basis.

 

[ClickerTicker]

Oops, sorry pellicle - I hadn't spotted you were in Oz. 7 UK units is around 5.5 Aus units. 12 UK units is a bit less than 10 Aus. I know your standard wine glasses are 150ml compared with our 175ml (but 250ml and 125ml are also available).

 

[pellicle]

Oops, sorry pellicle - I hadn't spotted you were in Oz. 7 UK units is around 5.5 Aus units. 12 UK units is a bit less than 10 Aus. I know your standard wine glasses are 150ml compared with our 175ml (but 250ml and 125ml are also available).

no wukkers ... cos you gave UK units I was able to google it. This one was handy:

https://metro.co.uk/2019/12/16/aust...g-guidelines-following-new-research-11913047/For example, an Australian ‘standard’ drink means 97ml of red wine at 13% alcohol volume. In UK terms, that’s just under a 125ml small wine glass – which measures in at 1.5 UK

which also had a link to here
https://yourroom.health.nsw.gov.au/games-and-tools/pages/standard-drink-calculator.aspx

in the spirit of Louis Wu (fictional character from Ringworld) I try to set up systems so that I can enjoy my tastes while protecting my body. So I use 60ml glasses and typically half fill them, strangely that seems to work at helping me sip it). As a double check, I also make sure that I don't drink more than 1/3rd of a bottle a night (and a bottle is typically 7.5 standard drinks here in Oz)

Thanks for your reply, while I know everyone is different its still good to get a measure.

Cheers