Prolonged effects of miconazole oral gel on warfarin anticoagulation even after treatment withdrawal

OBJECTIVE: We investigated the effect of terminating miconazole oral gel (MOG) treatment on the anticoagulant activity of warfarin by evaluating changes in international normalized ratio levels (INR). METHODS: Data were collected from the medical records of 6 patients treated with warfarin and MOG. RESULTS: Following cessation of MOG treatment, increased INR and INR/dose levels were observed for an average of 15 days, showing that the anticoagulant activity of warfarin was increased for ~ 2 weeks. CONCLUSIONS: Closer monitoring of INR levels for at least 2 weeks may be required upon withdrawal of MOG treatment in patients treated with warfarin.