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Rivaroxaban and fluconazole — GPhC CRA MCQ

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HardCardiovascular TherapeuticsRivaroxaban and fluconazoleGPhC CRA

A 71-year-old woman taking rivaroxaban 20 mg daily for AF is prescribed fluconazole 150 mg weekly for recurrent candidiasis. She has eGFR 38 mL/min/1.73 m2 and reports easy bruising. What is the most appropriate action?

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Correct answer: B — Query bleeding risk and interaction management before supplying fluconazole

Fluconazole can increase exposure to some anticoagulants, and renal impairment plus bruising increases concern about bleeding. The pharmacist should check the clinical plan and consider prescriber discussion, especially with repeated dosing. The patient should receive bleeding safety-netting and not stop anticoagulation without advice.

Reference: BNF; SPS