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Warfarin and fluconazole — GPhC CRA MCQ

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ModerateDrug InteractionsWarfarin and fluconazoleGPhC CRA

A 73-year-old woman taking warfarin is prescribed fluconazole 150 mg stat for vulvovaginal candidiasis. Her INR was 3.0 yesterday and she bruises easily. What is the most important interaction to flag?

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Correct answer: E — Fluconazole can increase INR and bleeding risk with warfarin

Fluconazole can inhibit warfarin metabolism and increase anticoagulant effect. Even single-dose therapy may be relevant in a frail or high-risk patient. INR monitoring and prescriber or anticoagulation clinic advice are appropriate. The patient should be counselled to report signs of bleeding.

Reference: BNF