Coumarin Anticoagulants/Econazole Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

If you apply econazole over large areas of your body or on skin that is broken or thin (e.g., groin), or you cover up areas where you applied econazole, econazole may be absorbed into your body more than usual. Once inside your body, econazole may slow down how quickly your body processes your blood-thinner.

What might happen:

The effect of the blood-thinner may increase.You may experience an increased chance for bleeding including bleeding from your gums, nosebleeds, unusual bruising, or dark stools.

What you should do about this interaction:

Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about using these two medicines together. If your doctor prescribes these medicines together, it may be necessary to check your bleeding times more often.Avoid applying econazole over large areas of your body or on skin that is broken, and avoid wrapping, covering, or bandaging areas where you applied econazole unless your doctor instructed you to do so.If you have any signs of bleeding, such as bleeding from your gums, nosebleeds, unusual bruising, or dark stools, contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Godamudunage MP, Grech AM, Scott EE. Comparison of Antifungal Azole Interactions with Adult Cytochrome P450 3A4 versus Neonatal Cytochrome P450 3A7. Drug Metab Dispos 2018 Sep;46(9):1329-1337.
  • 2.Lang PG Jr, LeClercq AH. Increase in anticoagulant effect of warfarin in a patient using econazole cream. J Am Acad Dermatol 2006 Nov;55(5 Suppl):S117-9.
  • 3.Wey PF, Petitjeans F, Lions C, Ould-Ahmed M, Escarment J. Laryngeal dyspnea in relation to an interaction between acenocoumarol and topical econazole lotion. Am J Geriatr Pharmacother 2008 Aug;6(3):173-7.
  • 4.Econazole US prescribing information. Alvogen, Inc. January, 2020.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.