Miconazole/warfarin interaction

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Elevated INR, gastrointestinal haemorrhage and haematuria: 4 case reports A case report described four patients including a 42-year-old man [ages and sexes of three patients not stated], who developed gastrointestinal haemorrhage, haematuria or exhibited an elevated INR following concomitant administration of miconazole and warfarin [dosage not stated; not all routes, indications and outcomes stated]. The patients in the United-Kingdom started receiving an anticoagulation therapy with warfarin along with miconazole. Of these four patients, the man had been receiving warfarin for multiple venous thromboembolism, and he subsequently started receiving miconazole oral gel for oral thrush. Following several weeks, the man presented to the clinic and was found to have an elevated INR at 16. Remaining three patients also exhibited INR above 10. Of these, two patients developed gastrointestinal haemorrhage (n=1) or haematuria (n=1). All the patients were admitted. The man’s warfarin therapy was discontinued and his elevated INR was successfully treated with vitamin K. All the other patients were also successfully treated during brief hospitalisation. Of these patients, the man was successfully restarted on warfarin. Buck DJ. Miconazole oral gel and warfarin interaction. Pharmaceutical Journal 288: No. 7704, 5 May 2012. Available from: URL: https://www.pharmaceutical-journal.com/ 803448514 opinion/correspondence/miconazole-oral-gel-and-warfarin-interaction/11100542.article

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Reactions 25 Jan 2020 No. 1788