Warfarin and topical miconazole: the potential for a clinically significant interaction

Population Impact of Drug Interactions with Warfarin: A Real-World Data Approach

“…About 10% of patients upon treatment with miconazole gel had INR values over 10 in our study, putting these patients at major risk of bleeding. Other authors have reported similar important interactions with oral gel, [25][26][27] vaginal suppositories 28 and, even, cutaneous formulations. 29 Altogether, these data warn against the concomitant use of VKA and topical miconazole, at least when used as oral gel.…”

Nystatin and miconazole: pharmacological and clinical evidence regarding interactions with warfarin

“…New reports of this interaction continue to be published reminding clinicians of its potential adverse effects. A paper in 2013 reported four cases of this interaction in patients attending an oral anticoagulation clinic in Ireland (Ufondu et al , ). A paper in 2015 reported four cases of this interaction in patients attending a cardiology department in Belgium (De Pauw and De Backer, ).…”