Interaction with Dramamine and absorption time

[yotphix]

If I could please, I'd like to survey the collected wisdom here with a two part question.
1: Does anyone know of any adverse interaction/contraindication between dramamine and warfarin?
2: Does anyone know how long, on average, it takes to absorb coumadin once you have taken it orally? In other words, how long is it sitting in your stomach unabsorbed? (And thus vulnerable to ejection if you are sick.)

I am asking because it does sometimes happen that I am in the unfortunate position of being stuck at sea in pretty deplorable conditions. Worst case so far was a (pre-surgery) trip between Panama and Grand Cayman where I was sick and unable to keep even a bit of water down for very long. The trip lasted about 72 hours.

What I am trying to do is make a plan to deal with such an eventuality should it come up again, especially since it is quite likely to when I make the same trip in the coming fall. I will speak to a physician about it but so far I have found that my own research and what I have gleaned from this forum is more useful than what the docs have on offer. At present, my first backup plan is to have preloaded lovenox syringes if all else fails (though I don't much look forward to trying to jab myself in the gut while jammed into the corner of my oscillating cabin).
Thanks for any input.

 

[ALCapshaw2]

My NON-Professional Guess is that it takes about 2 hours for Coumadin / Warfarin to be absorbed (hence the warning not to take antacids within 2 hours of taking anticoagulants). Note that it takes 3 or 4 days to become fully effective because it is a secondary reaction kind of function (I know that is clear as mud unless you already understand the mechanism).

If you are faced with losing your stomach contests for 72 hours, you may need to have some Lovenox Injections during that time. I can just imagine the 'Fun' of trying to self inject while riding in rough seas!

'AL Capshaw'

 

[ShezaGirlie]

There's not much as miserable as motion sickness, so I surely do sympathize with you.

FYI here's a link: http://www.drugs.com/drug-interactions/coumadin-with-dramamine-892-462-2311-1529.html

It explains interactions between your selected drugs: Coumadin and Dramamine

There were no interactions found in our database between Dramamine and Coumadin
However, this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

Goodluck and hope land is in sight in the near future for you..!!

 

[yotphix]

Thanks for the sympathy Janie, and for the confirmation that my findings were right. Of course, I will ask my physician and my local pharmacist just to be sure. And thank you Al, I don't recall that bit about the antacids but it certainly makes sense. I do know that the warfarin I take today is really protecting me three of four days down the road and that is actually part of what I will need to work out with the doc. Assuming that three days is the worst case scenario for continual sickness, I think that my INR wouldn't begin to dive until at least the second day if I wasn't able to keep pills in for a couple of hours. If that's true I might get away with injecting only on the last day and then afterward until I was back in range. At least that's my current take on it. The other factors that will come into play there is that it is almost impossible to avoid becoming dehydrated in that situation, and that those three days pass without food. I don't know what effect those things will have.
I should say, that it is entirely possible that I will make that passage without being sick at all. The seas need to be fairly big to turn me but it happened once three years ago and I need to be prepared in case it happens again.

 

[ALCapshaw2]

The rate at which INR drops seems to vary with individuals.
I'm thinking that it drops faster for high metabolizers than for slow metabolizers but it would be best to check with your Doc about that.

Either way, I'm pretty sure that after a 3 day hold your INR would be very close to 1.0
and several have reported very Low INR after a 2 day hold.

'AL Capshaw'

 

[njean]

My husband & I went on a cruise to Alaska a couple of years ago & I took Dramamine with us, just in care. I also made sure to check w/my cardiologist & PCP first to make sure it would not interfere with coumadin & they all assured me that it would not!

As it turned out neither one of us needed to take it & we had a fantastic trip! Hope yours goes well too!

 

[yotphix]

Thanks N Jean and Al,
Sorry to have disappeared for a few days there. I had frustratingly inadequate wifi in a Mexican marina. Back in the US today though. Al that is interesting, I wasn't aware that a two day hold would show a drop that was simultaneously conspicuous. I do self-test so that would be easy for me to keep track of, and if it did drop that rapidly I could begin the injections sooner.

I think what I will propose to the Doc is this: 1.Carry on as usual unless I begin to have trouble keeping things in. (As I said it needs to get pretty bad for that to happen.)
2. Have preloaded lovenox or equivalent on hand, say 5 doses to be safe.
3. Test daily if I'm unable to dose warfarin as normal.
4. Inject as soon as I fall out of range, continue injecting daily until I am able to get back into range.

Paul