MRCP(UK) Part 1 Practice Questions - MRCP(UK) Part 1 Exam

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A 68-year-old man with atrial fibrillation is started on amiodarone. Six weeks later his INR, taken because he is also on warfarin, has risen sharply despite no change in warfarin dose. Which mechanism best explains this interaction?

Amiodarone displaces warfarin from renal tubular secretion Amiodarone induces hepatic synthesis of clotting factors Amiodarone increases gut absorption of vitamin K Amiodarone inhibits CYP2C9 and CYP3A4, reducing warfarin metabolism

Correct Answer:

Amiodarone inhibits CYP2C9 and CYP3A4, reducing warfarin metabolism

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