Travelling safely with warfarin

Published in Medicinewise Living

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Learn how to travel safely with warfarin, so you can enjoy a fun-filled holiday. (Image:

Taking warfarin is one routine you don’t want to break while on holiday. If you — or someone you care for — are taking warfarin, you’ll know how important it is to take it exactly as prescribed and have your blood tested regularly.

Use these tips to help you stay safe with warfarin, so you can enjoy a fun-filled holiday.

See your doctor before you travel

Visit your doctor well before you leave. You may need an INR (International Normalised Ratio) test before you go. The test measures the time it takes for your blood to clot and helps your health professional to decide if your dose of warfarin needs to change.

You may also need to have your INR checked while travelling, especially if:

  • it’s not in your target range (usually INR 2–3) before you leave
  • you have just started taking warfarin
  • you start taking or are already taking another medicine known to affect your INR or warfarin.

Questions to ask your doctor

  1. What is my daily dose of warfarin?
  2. When do I take my warfarin if I’m crossing time zones?
  3. How should I store my medicines in very hot or cold climates?
  4. What do I do if I miss a dose of warfarin?
  5. What signs and symptoms of bleeding do I look out for, and when do I seek medical advice or go to a hospital emergency department?
  6. Do I need to have my INR tested while I’m away, and if so, how do I do this?
  7. What vaccines do I need?

Carry enough warfarin for the whole trip

Don’t forget to pack more than enough warfarin and your other medicines for your holiday. Keep your medicines in your carry-on baggage in case your checked-in luggage is lost or delayed, and carry a copy of your doctor's prescription for each of your medicines.

Make an up-to-date list of all your medicines and carry it with you. This will be important if you need medical attention while you are away. Make a note of your usual brand (Marevan or Coumadin), because unlike most other medicines, it’s important to always stick with the same brand of warfarin. Order or download an NPS Medicines List or download the free iPhone app from the App Store.

Record your current daily dose of warfarin and your last 10 INR readings.

Take warfarin at the same time every day

One way to help keep your INR stable is to take warfarin exactly as directed by your health professional and at the same time each day, which can be easier said than done when you’re on holiday. Set an alarm or a reminder on your mobile phone to help you remember.

If you miss one or more doses, keep a note of this and let your health professional know when you get home. Don’t take a double dose at anytime.

If you accidentally take a double dose, or you don’t know what to do if you’ve missed a dose, seek medical advice as soon as possible or call the NPS Medicines Line on 1300 MEDICINE (1300 633 424).

Know what can affect your INR

Some foods and drinks, as well as illness and other medicines (including vitamins and herbal supplements), can affect your INR.

Trying the local cuisine is part of the experience when you’re on holiday, but keep your diet as consistent as possible while you’re away. Limit your alcohol intake to no more than two standard drinks per day.

It’s important to eat a consistent amount of green leafy vegetables containing vitamin K each week as part of your normal diet. This will help keep your INR stable, as foods rich in vitamin K can affect your INR. This does not mean you should exclude vitamin-K rich foods from your diet. A balanced intake of Vitamin K is an essential part of everyone’s diet, even if you are taking warfarin. Green leafy vegetables such as spinach, cabbage, broccoli and certain types of lettuce, are all rich in vitamin K.

Keep yourself safe on holiday

Avoid any activities that may put you at risk of bleeding from injuries or falls, or take precautions to limit your risk. For example, if you’re cycling, wear protective clothing such as gloves, cycle helmets, knee padding and non-slip supportive shoes.

Safety is important indoors too. Ask for a non-slip bathmat for the bath or shower in your accommodation. Use an electric shaver and a soft-bristled or electric tooth brush.

Carry dressings with you in case you scratch or cut yourself and start to bleed. Consider taking a first aid course before you travel so you know how to manage cuts or injuries until you can seek medical advice.

Report any injuries to a health professional — including falls, bruising and accidents — even if you don’t notice any bleeding.

When to seek medical help

Seek urgent medical advice if you notice:

  • unusual bruising or bleeding
  • any unusual symptoms
  • vomiting or diarrhoea
  • fever or infection
  • loss of appetite
  • yellowing of the skin or whites of the eyes (jaundice).

If you need medical help while away, tell any health professional caring for you that you are taking warfarin, and show them your medicines list, especially before starting any new medicines or treatments. If you are ill or prescribed a medicine while on holidays, tell your doctor when you return.

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