Miconazole Coumarins

Drugs that may affect repaglinide include CYP 450 inhibitors (eg, clarithromycin, erythromycin, ketoconazole, miconazole), CYP 450 inducers (eg, barbiturates, carbamazepine, rifampin), beta blockers, calcium channel blockers, chloramphenicol, corticosteroids, coumarins, estrogens, gemfibrozil, isoniazid, itraconazole, levonorgestrel and ethinyl estradiol, MAOIs, nicotinic acid, NSAIDs, oral contraceptives, phenothiazines, phenytoin, probenecid, salicylates, simvastatin, sulfonamides, sympathomimetics, thiazides and other diuretics, and thyroid products. 

Drug interactions NSAIDs Salicylates Sulfonamides Chloramphenicol Probenecid Coumarins MAO inhibitors Beta-blockers Thiazides and other diuretics Corticosteroids Phenothiazines Thyroid products Estrogens Oral contraceptives Phenytoin Nicotinic acid Sympathomimetic Calcium channel blockers Isoniazid Miconazole... 

Clinically important, potentially hazardous interactions with beta andrenergic blocking agents, chloramphenicol, cimetidine, dofibrate, coumarin deriveratives, disopyramide, MAO inhibitors, miconazole, phenylbutazone, salicylates, sulphonamides, tetracycline... 

This drug is indicated for infections of skin and nails due to dermatophytes or Candida species and vulvovaginal infections due to Candida species. Miconazole is used orally for prophylactic purposes in patients who have been treated with cytostatics or immunosuppressants, in particular, to prevent candidosis of the mouth and digestive tract. Side effects include possible nausea during oral treatment. Miconazole tablets may increase the anticoagulant effect of coumarin derivatives. Topical treatment with cream or powder is well tolerated. Local irritation and alleigic reactions of the skin and mucosa occur only rarely. 

Based on this information the risk of a clinically relevant drug interaction with systemically administered drugs and these topical azoles would seem to be very small. However, for a case report of raised INR in a man taking warfarin while using miconazole cream for a groin infection, see Coumarins and related drugs + Azoles Miconazole , p.388. 

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