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Publication Type: OBS Messages
Single or Multiple Incident: Multiple
Date: 6/30/2017 12:00:00 AM
Country: Denmark

This alert highlights the drug-drug interaction between an anticoagulant, warfarin, and an anti-fungal, miconazole. The interaction between warfarin and miconazole increases the effect of warfarin, so that the blood-thinning ability (INR) is increased, which in turn can cause severe bleeding. The risk of interaction also applies to miconazole oral gel, as a large proportion of this is absorbed systemically. Other antifungals such as fluconazole and voriconazole have the same effect on warfarin. A recommendation to prevent adverse events when it is necessary to use warfarin and an antifungal concomitantly is provided.

Additional Details

Medication/Gas/Fluid:
anticoagulants, warfarin (Marevan®), antifungals, miconazole, miconazole oral gel (Brentan®), fluconazole, voriconazole, nystatin
Medication/IV List:
antithrombotic agents (anticoagulants),


Be aware of the interaction between warfarin and miconazole oral gel