What is an important drug interaction to monitor with azole antifungals?

Monitoring the interaction between azole antifungals and warfarin is crucial because azoles can inhibit the cytochrome P450 enzymes, particularly CYP2C9, which are responsible for metabolizing warfarin. This inhibition can lead to increased blood levels of warfarin, thereby enhancing its anticoagulant effect and elevating the risk of bleeding. Patients on both azole antifungals and warfarin require careful management, including more frequent monitoring of INR (International Normalized Ratio) to ensure the anticoagulant effect remains within a safe range.

This significant interaction highlights the need for vigilance when prescribing antifungal agents in patients who are also receiving anticoagulant therapy. Other interactions, while also relevant, do not present the same level of risk or require as much careful management when it comes to antifungal therapy.