fluconazole + warfarin

Fluconazole + warfarin refers to the co-administration of the triazole antifungal fluconazole and the coumarin anticoagulant warfarin. This specific combination was the focus of a pharmacogenetics study at the University of Minnesota (NCT00134069) investigating how CYP2C9 genetic variations (*2 and *3 alleles) influence the drug-drug interaction between these two medications. Warfarin acts by inhibiting Vitamin K epoxide reductase complex subunit 1 (VKORC1), which prevents the recycling of vitamin K and the subsequent activation of clotting factors II, VII, IX, and X. Fluconazole is a moderate inhibitor of the CYP2C9 enzyme, which is the primary metabolic pathway for the more potent S-enantiomer of warfarin. The interaction leads to decreased warfarin clearance and an increased risk of over-anticoagulation and bleeding, a phenomenon that varies significantly based on an individual's CYP2C9 genotype.

Other names

fluconazole and warfarin