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Pharmacy Times – December 2016

 

Drug Interactions: Insights and Observations

 

Miconazole Oral Gel Drug Interactions

 

John R. Horn, PharmD, FCCP and Philip D. Hansten, PharmD

 

 

References

 

1 Watson PG, Lochan RG, Redding VJ. Drug interaction with coumarin derivative anticoagulants. BMJ. 1982;285:1045-6.

2 Silingardi M, Ghirarduzzi A, Tincani E, et al. Miconazole oral gel potentiates warfarin anticoagulant activity. Thromb Haemost. 2000;83:794-5.

3 Pemberton MN, Sloan P, Ariyaratnam S, et al. Derangement of warfarin anticoagulation by miconazole oral gel.Br Dent J. 1998;184:68-9.

4 Shenfield GM, Page M. Potentiation of warfarin action by miconazole oral gel.

 Aust N Z J Med. 1991;21:928.

5 Pemberton MN, Oliver RJ, Theaker ED. Miconazole oral gel and drug interactions. Br Dent J. 2004;196:529-31.

6 Miki A, Ohtani H, Sawada Y. Warfarin and miconazole oral gel interactions: analysis and therapy recommendations based on clinical data and a pharmacokinetic model. J Clin Pharm Ther. 2011;36:642-50.

7 De Pauw A, De Backer T. Miconazole buccal gel and risk for systemic bleeding: how certain topical formula can interfere with anticoagulants. Acta Clin Belg. 2015;70:121-3.

8 Murakami S, Tanaka A, Ido K, et al. Prolonged effects of miconazole oral gel on warfarin anticoagulation even after treatment withdrawal. Int J Clin Pharmacol Ther. 2016;54:474-6.

9 O'Reilly RA, Goulart DA, Kunze KL, et al. Mechanisms of the stereoselective interaction between miconazole and racemic warfarin in human subjects. Clin Pharmacol Ther. 1992;51:656-67.

10 Gronlund J, Saari TI, Hagelberg N, et al. Miconazole oral gel increases exposure to oral oxycodone by inhibition of CYP2D6 and CYP3A4. Antimicrob Agents Chemother. 2011;55:1063-7.

11. Ishiwata Y, Nagata M, Arai T, et al. Effects of miconazole oral gel on blood concentrations of tacrolimus and cyclosporine: a retrospective observational study. Ther Drug Monit. 2016; PMID:27559841, Epub ahead of print.