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Warfarin and miconazole oral gel — GPhC CRA MCQ

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ModerateDrug InteractionsWarfarin and miconazole oral gelGPhC CRA

A patient on warfarin asks to buy miconazole oral gel for suspected oral thrush. He has had several recent INR dose adjustments. What is the most important interaction to flag?

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Correct answer: E — Miconazole can markedly increase warfarin effect

Miconazole, including oral gel, can significantly increase warfarin anticoagulant effect and bleeding risk. The pharmacist should avoid over-the-counter supply without prescriber or anticoagulation advice. A safer antifungal plan may be needed.

Reference: BNF; MHRA