Warfarin and Anti Fungal products war... - Heart Rhythm Diso...

Heart Rhythm Disorders Support

6,992 members2,924 posts

Warfarin and Anti Fungal products warning.

seasider18 profile image
2 Replies

There is a warning in this months BNF.

•Miconazole, including the topical gel formulation, can enhance the anticoagulant effect of warfarin—if miconazole and warfarin are used concurrently, the anticoagulant effect should be carefully monitored and, if necessary, the dose of warfarin reduced

•Patients should be advised to tell their doctor or pharmacist if they are receiving warfarin before using products that contain miconazole (including those available without prescription), and to seek medical advice if they notice signs of over-anticoagulation during treatment, such as sudden unexplained bruising, nosebleeds or blood in the urine

Miconazole (Daktarin, Daktacort) is an antifungal indicated for prevention and treatment of various infections of the mouth, throat, skin, nails, or genitals. It is usually applied topically as a cream, ointment, powder, or oral gel. Some products are available without a prescription.

Warfarin is an oral anticoagulant that has been widely used since the 1950s for prophylaxis of thromboembolic events. Daily dose depends on individual requirements, and patients receiving long-term therapy require regular coagulation tests.

Drug interactions

The potential for drug interactions between miconazole and warfarin is well established1 2 3. The mechanism is understood to be inhibition by miconazole of one of the main cytochrome P450 isozymes involved in warfarin metabolism (CYP2C9), resulting in reduced warfarin clearance and an enhanced anticoagulant effect.

Prescribing information for products that contain miconazole warns that because miconazole inhibits CYP2C9, caution should be exercised for patients on oral anticoagulants such as warfarin, and the anticoagulant effect monitored (warfarin dose reduction may be needed). Patient Information Leaflets for miconazole products advise users to tell their doctor or pharmacist if they are taking warfarin.

Written by
seasider18 profile image
seasider18
To view profiles and participate in discussions please or .
Read more about...
2 Replies
NiceNana profile image
NiceNana

Does it say anything about the effect on Rivaroxaban? I have been prescribed a cream containing Miconazole by my GP for a sore toe. Told it was ok.

seasider18 profile image
seasider18 in reply toNiceNana

It just says warfarin not the NOACs

Not what you're looking for?

You may also like...

Collapse, without warning

Hi, I am a newbie to the site, last year we thought a collapse without any warning was a one off,...
Harley50 profile image

Tachycardia, missed beats, anti arrhythmics.. and no relief

Hi everyone, I've been diagnosed with an arrhythmia that's likely to be IST or SNRT. The EP...
KRG13 profile image

Ablation recovery off medication except warfarin.

I am in a dilemma as to how easy (or not) to take things. And whether or not to seek medication....

Ectopics and palpitations

Hi I am 28 and I have been getting ectopics and palpitations for several years, recently they have...
sutty88 profile image

svt and prednisolone

I'm currently taking 27.5mg prednisolone for GCA and have svt which has been controlled by...
maria40 profile image

Moderation team

See all
HollieAdmin profile image
HollieAdminAdministrator
Kelley-Admin profile image
Kelley-AdminAdministrator
Emily-Admin profile image
Emily-AdminAdministrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.