Flying on Blood Thinners: What You Need To Know About Apixaban And Warfarin
Written by: Sarah Findlay Travel Insurance Expert
Reviewed by: Dr Ellen Welch NHS GP and resident medical expert
Read time: 7 minutes
Being prescribed a blood thinner like apixaban or warfarin doesn't mean your travelling days are over, but it does mean a little extra planning before you fly. If you've found yourself asking, “Can I fly while taking apixaban?” the short answer is yes for most people. The longer answer involves understanding your own risk of clotting, packing your medication properly, and making sure your travel insurance actually covers you.
Quick Reads [TLDR]
Yes, you can fly while taking apixaban or warfarin, and doing so is routine for most people on anticoagulants. The main things to plan around are staying on schedule with your dose, moving regularly to reduce clot risk, and declaring your condition and medication when you take out travel insurance.
Why are apixaban and warfarin prescribed?
Apixaban and warfarin are two commonly prescribed anticoagulants, often called blood thinners. Other anticoagulants are also available, but this article focuses on these two medicines. They reduce the blood's ability to form clots and may be prescribed to prevent strokes in people with atrial fibrillation, or to treat or prevent DVT and pulmonary embolism. Warfarin is also used for people with mechanical heart valves (apixaban is not suitable for this purpose). Apixaban may also be prescribed after hip or knee replacement surgery.
Can I fly while taking apixaban? The key risks to plan for
Taking apixaban or warfarin does not usually prevent you from flying, but it is worth considering your underlying health condition and planning a few practical details before you book.
- DVT and clot risk: Long periods of sitting still on a flight can increase clot risk for anyone.
- Bleeding risk: Both apixaban and warfarin increase your risk of bleeding, so bumps, falls, injuries while travelling can be more serious than usual. Seek urgent medical advice if you sustain a head injury.
- Missed or mistimed doses: Time-zone changes can disrupt your medication routine. Keeping to your prescribed schedule matters with both medicines, so ask your pharmacist or anticoagulation team how to manage doses during your journey.
- INR monitoring abroad: If you take warfarin, check whether an INR test will be due while you are away and arrange access to testing if needed. Please be aware that your insurance policy may not cover planned medical treatment while you are away.
- Food, alcohol and medication interactions: If you take warfarin, aim to keep your intake of vitamin K-containing foods, such as green leafy vegetables, consistent rather than avoiding them. Before taking any new medicines or supplements, including over-the-counter remedies, please check with a pharmacist. Some medicines and supplements can interact with anticoagulants.
Please make sure you do this before getting a quote, so you can tell us about any medicines or supplements you are taking. If a new medicine or supplement interacts with your anticoagulant and this has not been declared, the interaction may not be covered if you need to make a claim.
Checklist: Tips for flying safely on blood thinners
A little preparation can help you travel with confidence. If you have recently been unwell or are unsure whether your condition is stable, check with your treating team before flying.
- Carry your medication details: Take an up-to-date medication list or copy or your prescription together with your anticoagulant alert card. Check the entry requirements of your destination and whether your airline requires medical documentation. A doctor's letter may be useful or required in some circumstances
- Pack medication in your hand luggage: Keep it in its original packaging with the prescription label, and carry enough for the whole trip plus a few extra days in case of delays.
- Move regularly during the flight: Flex your ankles and tighten your calf muscles while seated. Get up and walk regularly when it is safe to do so, following cabin-crew instructions.
- Stay hydrated: Dehydration and alcohol can both affect how your blood thinner works, so pace yourself, especially with warfarin.
- Ask whether compression stockings would help: They may be useful for some travellers but are not automatically needed because you take an anticoagulant. Ask your treating team whether they are appropriate and ensure they fit correctly.
- Plan around time zones: Ask your pharmacist or anticoagulation team how to maintain your prescribed dosing intervals on both the outward and return journeys. Keep taking your usual prescribed dose; do not add extra doses of aspirin for the flight unless specifically advised.
When you should think twice about flying
Most people taking anticoagulants can fly when their condition is stable. Speak to your treating team before travelling if:
- You have recently started or changed treatment and are experiencing side effects, or your underlying condition is not yet well controlled.
- You have had a recent significant bleed, DVT, pulmonary embolism or related hospital admission.
- Your INR has been unstable or outside your target range while taking warfarin
After a DVT or pulmonary embolism, British Thoracic Society guidance recommends delaying flying for two weeks. Some people need longer, so check with the team treating you rather than assuming you are fit to fly once two weeks have passed.
Seek advice well before departure, particularly for long-haul journeys or destinations where access to medical care is limited.
Declaring apixaban or warfarin for travel insurance
When buying travel insurance, declare the condition for which you take apixaban or warfarin and answer the medical-screening questions accurately, including those about medication and recent treatment. This applies even if you feel well and your condition is stable.
If you don't declare it and need emergency treatment abroad related to a clot, a bleed, or the underlying condition, your policy could be invalidated. That can leave you covering the cost of overseas hospital treatment, medication, and repatriation yourself, which for a serious clotting or bleeding event can run into tens of thousands of pounds.
Here at Total Travel Protection, we believe being on a blood thinner shouldn't stop you from seeing the world. We make our medical screening process straightforward, so you can declare your pre-existing conditions and travel honestly and get proper cover in place, giving you the confidence to book your next trip.
FAQs: Flying on apixaban or warfarin
Most people taking apixaban can fly without issue. The main precautions are staying mobile during the flight, keeping to your dosing schedule, and carrying your medication in your hand luggage with its original packaging. If you have recently had a clot, significant bleeding or a hospital admission, seek advice from your treating team before travelling.
Usually, provided your underlying condition and anticoagulation are stable. Check whether an INR test will be due during your trip and arrange testing and follow-up if needed. Ask your pharmacist or anticoagulation team how to manage doses across time zones.
No. Apixaban and warfarin reduce the risk of blood clots, although they do not eliminate it completely. Continue your prescribed treatment and move regularly during long journeys. Do not take extra doses or add aspirin for the flight unless your treating clinician specifically advises it.
Yes. Declare atrial fibrillation during medical screening, even if it is well controlled, and answer questions about your medication accurately. Check that your insurer has accepted the condition for cover and whether any exclusions apply.
Yes. Apixaban and warfarin tablets can be carried in hand luggage. Keep them in their labelled packaging and carry your medication list and anticoagulant alert card. A doctor’s letter is not routinely required for tablets at UK airport security, but check your destination’s medicine-import rules and any requirements for medical equipment or injectable medicines.