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Warfarin and amiodarone — GPhC CRA MCQ

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HardCardiovascular TherapeuticsWarfarin and amiodaroneGPhC CRA

A 73-year-old woman stabilised on warfarin for AF has a new discharge prescription for amiodarone 200mg daily after admission with tachyarrhythmia. Her latest INR was 2.4 five days ago. She also takes levothyroxine, furosemide and lansoprazole. What is the most important interaction to flag?

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Correct answer: A — Amiodarone may increase warfarin effect and INR

Amiodarone can increase anticoagulant effect with warfarin, increasing bleeding risk and often requiring closer INR monitoring and dose adjustment. The interaction can be clinically important and may develop over days to weeks. The other medicines listed do not create the most important immediate safety issue here. The pharmacy should flag the interaction and ensure an anticoagulation plan is in place.

Reference: BNF Warfarin interactions; BNF Amiodarone