Warfarin Institute of America
Dedicated To Your Health
MICONAZOLE INTERACTION WITH WARFARIN
Brand Name: Monistat
This can be a fairly serious interaction that can happen whether you are using the oral tablets or the vaginal cream. The implication is that the vaginal cream must be getting absorbed into the bloodstream for this to happen. Perhaps that only happens when there is a significant area of broken skin. That would account for why this happens with some people and not others.
A reliable person reported that her CoaguChek would not give a reading after she had used the vaginal cream for several days. She then went to a lab and had her INR checked there. The result came back at 8.1. Since the upper limit that the CoaguChek will read is 8.0, this makes sense.
She held the warfarin dose and the INR decreased and no harm was done. However, the potential was there for a significant bleed.
If you are taking warfarin and start using any form of miconazole, you should have your INR checked 3 to 5 days into the therapy.
This reaction also happens with other members of this family: econazole, fluconazole, itraconazole, ketoconazole, metronidazole and voriconazole.
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Last updated November 14, 2004