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Warfarin and miconazole oral gel — GPhC CRA MCQ

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HardCardiovascular TherapeuticsWarfarin and miconazole oral gelGPhC CRA

A patient taking warfarin asks to buy miconazole oral gel for suspected oral candidiasis. Their INR has been stable for several months. What is the most important interaction to flag?

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

Reveal the answer and explanation

Correct answer: A — Increased anticoagulant effect and bleeding risk

Miconazole can markedly increase warfarin exposure and INR, so the combination should be avoided or closely managed. In this vignette, "Increased anticoagulant effect and bleeding risk" is the safest single best answer. The other options are less appropriate because they miss the key clinical risk, conflict with UK medicines guidance, or delay needed review.

Reference: https://www.pharmacyregulation.org/registration-assessment#stage-8-order-84