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Warfarin and miconazole oral gel — GPhC CRA MCQ

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ModerateDrug InteractionsWarfarin and miconazole oral gelGPhC CRA

A 73-year-old man taking warfarin asks to buy miconazole oral gel for denture-related oral thrush. His INR has been stable for several months. What is the most appropriate alternative?

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Correct answer: C — Nystatin oral suspension after assessment if treatment is suitable

Miconazole oral gel can interact significantly with warfarin and increase bleeding risk. This can occur despite topical oral use because systemic absorption is sufficient to matter. A non-interacting antifungal option such as nystatin may be preferred after assessment and relevant prescribing checks.

Reference: BNF; MHRA advice