Traveling to a different time zone, when to take warfarin

[KLS39]

I will be traveling next month to Europe which is 5 hours ahead. I currently take my warfarin at 6:30 PM. What do you all do when you travel to a different time zone? I will ask my cardiologist at my appointment this week but wanted to ask here as well.

Thanks in advance.

 

[pellicle]

when I've gone (multiple times) to and from Finland (from Australia) to live for a while. I've just taken my dose at the same time at my destination time. I mean I have to adjust right, like you get up earlier, and go to bed earlier but that only matters if you try to artificially remain on your home time rather than move.

There has never been any alteration in my INR, which I would expect there isn't and expect there shouldn't be because its got such a long half life (approx 2 days) so quite an amount remains in your system at all times.

no different to:

• changing your dosage time from AM to PM (people do that if one or the other becomes inconvenient)
• missing a dose and taking it in the AM (or PM)

 

[ATHENS1964]

I take the pill at 18.00 if I am going to travel to a country that has +2 or -2 hours
I do not do anything I usually just take it at 20.00 or 16.00 in the destination country if I have to change it for some reason a few days before it travels I steal stepwise some time + or - and when I reach the destination now I have adjusted the time of taking the pill

 

[Cooker]

I take mine in the morning regardless of where I am. We travel abroad fairly often. It’s never been an issue. My INR remains stable.
No worries!

 

[Al3x]

I have a related question. Is there anything to check when traveling abroad with warfarin regarding bringing medicine into another country or arranging an emergency dose if you lose your meds? I expect it varies by country but I would be interested to hear people's experiences.

 

[pellicle]

Is there anything to check when traveling abroad with warfarin regarding bringing medicine into another country

I use the brand Marevan. As it happens its sold in Finland as well as Australia. When I bought that I found no observable change in the trend of my INR.

This is of course »why we self test« and preferably self manage.

We become the experts in ourselves and not some perpetually dependent patient.

Many here have reported no one change from brand changes, others have reported a change. But it doesn't matter, if you self test the only criteria for dose is INR.

So if your INR goes up, (for instance) reduce your dose in accordance with the readings.

Imagine you are diving a car, you approach a hill and so your car starts going slower. What should you do ... put your foot on the pedal.

It really is that simple

 

[Superman]

I just take mine in the morning before I let the dogs out. If I’m up at 5:00, that’s when I take it. If I sleep in until 8:00, that’s when I take it. If I’m in another time zone, I leave the dogs home but still take it when I get up. If I forget to take it, I take it when I remember.

I’ve never found a couple hours either direction to be an issue.

 

[pellicle]

before I let the dogs out

well ... now we know!

 

[Juli]

I use the Medisafe app to remind and track medications and stay on the original timezone in the app when traveling. I never had any trouble bringing my medications to other countries. However now with Covid I do take at least another week of medications with me - just in case.

 

[LondonAndy]

I find there are more significant factors when I change time zone, such as a change of diet or increase in alcohol consumption. I tend to take my Warfarin when I have my evening meal, and continue to do that when abroad, and so increase my testing frequency anyway. Ah, the joys of self testing and managing

 

[newarrior]

I take mine in the morning regardless of where I am. We travel abroad fairly often. It’s never been an issue. My INR remains stable.
No worries!

Are you able to adjust your dose to match up with the last time so you're in? I mean if I'm just going to Vietnam or Singapore or even Japan where it's only 0 to 2 hours difference no big deal I guess but if I'm going to jump back to America for a visit for a month that's 14 to 11 hours difference from asia.

 

[newarrior]

I find there are more significant factors when I change time zone, such as a change of diet or increase in alcohol consumption. I tend to take my Warfarin when I have my evening meal, and continue to do that when abroad, and so increase my testing frequency anyway. Ah, the joys of self testing and managing

What happens if your diet gets thrown off big time because you're in a different city country or state? What if you're like 10 or 14 time zones off?

 

[pellicle]

What if you're like 10 or 14 time zones off?

when people talk about body clocks they don't actually mean you have a Seiko inside. So your body doesn't know about which timezone you are in.

As I've mentioned to you several times before, I travel to Finland from Australia (before COVID) and you should check out how many time zones I cross... never been a problem.

but please, don't get a mechanical. I'm already worried about the messages you'll be sending the group about your INR

 

[dick0236]

Like the other posters, I take my warfarin in the AM when I wake up......regardless of time zone or country.

 

[Superman]

What if you're like 10 or 14 time zones off?

Isn’t that the same thing?

 

[DaliaMooney]

Maintaining consistency with your medication schedule is crucial for managing your condition effectively. However, when traveling to a destination with a significant time difference like Europe, it's understandable to be concerned about how to adjust your dosing routine.
Also, you may find it helpful to explore additional resources on managing medication while traveling. I recommend checking out this informative guide on the topic: see here. It offers practical tips and insights to help you navigate the challenges of traveling with medication.

 

[pellicle]

Maintaining consistency with your medication schedule is crucial for managing your condition effectively.

Taking warfarin is not like a watch movement. You can shift your taking time and then maintain that new time with no measurable change in INR.

I've done this many times (as stated above).

Equally you can change from AM taking to PM taking (and then continue that) too.

Alternating between the two regions on a day to day basis or missing days is absurd.

I've moved from living in Finland to Australia a fee times between 2013 and now.

As Superman observed an hour or even half a day either way won't matter (on the odd occasion).

KEY to all of this is that we are talking warfarin, not Acenocoumarol (eg Sintrom), its key because they have different half lives.

https://en.wikipedia.org/wiki/Acenocoumarol

https://en.wikipedia.org/wiki/Warfarin

 

[Protimenow]

Like the others have said, warfarin's half life is LONG - two or three days. Changing the time that you take warfarin isn't as significant as it would be with a medication with a short half life - perhaps some heart medications are effective for only 12 hours - the time that you take these MAY have some impact on how you feel.

Warfarin is nowhere near as sensitive. It's not something that you have to take the same time every day.

Similarly, you don't have to have a lab test your INR within minutes of testing with your meter - the INR takes a while to change.

If I was the person traveling, I'd probably take it about the same time, local time, and not worry about it.

 

[Baldwinablin]

When you're traveling across time zones, adjusting the timing of your warfarin dose can definitely be a bit tricky. It's important to aim for consistency with your dosing time, but with the time difference, you might need to shift it gradually.

Since you're going to be 5 hours ahead, you might want to consider splitting the difference and adjusting the time slowly once you get there, rather than making the whole shift at once.

 

[Protimenow]

You don't have to take Warfarin at the same time each day. It's not that kind of medication. The half life is DAYS - taking it a few hours earlier or later than you usually do won't have much - if any - difference in your anticoagulation or your INR.
As long as you take it - don't miss or double a dose - you should be fine. It's not at all critical - take it daily, don't obsess about taking it at the same time each day or splitting doses.