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Fluconazole apixaban — GPhC CRA MCQ

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ModerateDrug InteractionsFluconazole apixabanGPhC CRA

A patient taking apixaban has recent nosebleeds and is prescribed fluconazole. What is the most important interaction to flag?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Fluconazole may increase apixaban exposure and bleeding risk

Azole antifungals can inhibit pathways involved in DOAC metabolism and transport. In this scenario, the pharmacist should prioritise safe supply, appropriate counselling and timely referral or clarification where needed. This is the single best answer because the other options would either delay assessment, ignore a clinically significant risk, or create an unsafe legal or professional outcome.

Reference: BNF