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Warfarin and miconazole oral gel — GPhC CRA MCQ

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HardDrug InteractionsWarfarin and miconazole oral gelGPhC CRA

A patient taking warfarin asks to buy miconazole oral gel for denture-related thrush. His INR has been stable for months. What is the most important interaction to flag?

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Correct answer: B — Miconazole can markedly increase warfarin effect and bleeding risk

Miconazole oral gel can be systemically absorbed enough to inhibit warfarin metabolism and raise INR. Serious bleeding has been reported. An alternative antifungal or anticoagulation service advice is required.

Reference: BNF; MHRA Drug Safety Update