Acenocoumarol and Fluconazole: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Acenocoumarol and Fluconazole unless specifically directed by your doctor.
How Acenocoumarol interacts with Fluconazole
Fluconazole inhibits CYP2C9 and CYP3A4, reducing metabolism of acenocoumarol and markedly increasing anticoagulant effect with elevated INR and bleeding risk.
What you should do
Avoid combination if possible; if co-administration is necessary, reduce acenocoumarol dose by 25-50% and monitor INR every 2-3 days during initiation and after fluconazole discontinuation.
Key facts
Severity
Major — avoid combination
Mechanism
Fluconazole inhibits CYP2C9 and CYP3A4, reducing metabolism of acenocoumarol and markedly increasing anticoagulant effec...
Action
Avoid combination if possible; if co-administration is necessary, reduce acenocoumarol dose by 25-50% and monitor INR ev...
Frequently asked questions
Can I take Acenocoumarol and Fluconazole together?
No — this combination should generally be avoided. Avoid combination if possible; if co-administration is necessary, reduce acenocoumarol dose by 25-50% and monitor INR every 2-3 days during initiation and after fluconazole discontinuation.
What is the severity of this interaction?
The interaction between Acenocoumarol and Fluconazole is classified as Major — avoid combination. Fluconazole inhibits CYP2C9 and CYP3A4, reducing metabolism of acenocoumarol and markedly increasing anticoagulant effect with elevated INR and bleeding risk.
What should I do if I'm prescribed both?
Avoid combination if possible; if co-administration is necessary, reduce acenocoumarol dose by 25-50% and monitor INR every 2-3 days during initiation and after fluconazole discontinuation. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.