title: [Interaction between warfarin and oral miconazole gel].
abstract: We report a case of a 76 year-old woman who had been taking warfarin for seven years because of relapsing deep venous thrombosis. Her daily maintenance dose was 5 mg. Monthly measurements of international normalised ratio (INR) were stable between 2-3. She developed oral candidiasis and miconazole gel was prescribed. One week later she developed bleeding gums. Eight days later she was admitted to the hospital with haematuria. INR was > 10. Warfarin and the miconazole gel were withdrawn. She was treated with phytonadione. INR normalised after four days and she continued warfarin treatment. Caution should be exercised whenever the combination of warfarin and miconazole gel are prescribed.
authors.affiliation: Medicinsk afdeling E, Amtssygehuset i Herlev.
authors.forename: C G
authors.initials: CG
authors.lastname: Ogard
authors.forename: H
authors.initials: H
authors.lastname: Vestergaard
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002180:Candidiasis, Oral / Q000188:drug therapy; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008825:Miconazole / Q000008:administration & dosage / Q000009:adverse effects*; D020246:Venous Thrombosis / Q000188:drug therapy; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics
chemical_list: D000925:Anticoagulants; D000935:Antifungal Agents; D014859:Warfarin; D008825:Miconazole