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Warfarin counselling — GPhC CRA MCQ

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HardPatient Counselling and Pharmaceutical CareWarfarin counsellingGPhC CRA

A 67-year-old man newly started on warfarin for AF collects his first community prescription. He also buys miconazole oral gel for denture soreness and says he enjoys cranberry juice daily. What would you advise the patient?

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Correct answer: C — Avoid miconazole oral gel and seek advice about interacting products and INR monitoring

Miconazole oral gel can significantly interact with warfarin and increase bleeding risk, so it should be avoided unless specifically managed. Warfarin counselling should include INR monitoring, bleeding signs and checking before starting OTC medicines. Dietary vitamin K intake should be consistent rather than eliminated. Timing changes do not reliably remove many warfarin interactions.

Reference: BNF; NICE CKS Anticoagulation oral