In a patient taking warfarin, which Parkinson's medication would be contraindicated?

• A. Selegiline
• B. Ropinirole
• C. Amantadine
• D. Benztropine

Answer: (B)

Warfarin is a tightly balanced anticoagulant, so any Parkinson’s medication that can alter bleeding risk or interact with liver enzymes used to metabolize anticoagulants needs close scrutiny. Ropinirole, a dopamine agonist, has a higher potential for interaction with warfarin that could elevate the anticoagulant effect and increase bleeding risk, making it contraindicated in someone on warfarin. The other options don’t carry the same level of concern for warfarin interaction in typical practice: selegiline can have important interactions with other drug classes but is not a direct warfarin contraindication; amantadine and benztropine don’t significantly affect warfarin’s anticoagulant pathway. In clinical terms, avoid combining ropinirole with warfarin and monitor any necessary alternatives carefully for coagulation changes.