Aspirin NSAID Interaction — ORE Part 1 MCQ

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ModeratePharmacology & TherapeuticsAspirin NSAID InteractionORE Part 1

A 55-year-old patient takes aspirin 75 mg once daily, atorvastatin 20 mg once daily and ramipril 5 mg once daily. Following an uncomplicated extraction, the dentist is considering prescribing an analgesic. Which regular medicine is the main reason to avoid routine ibuprofen prescribing?

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Correct answer: C — Aspirin

The correct answer is C. Aspirin indicates antiplatelet treatment, usually for vascular disease. SDCEP discourages NSAID use in patients with vascular disease because of NSAID antiplatelet effects; simple analgesics such as paracetamol or co-codamol should be considered first. In this context, routine ibuprofen is undesirable because concomitant NSAID use can increase bleeding and gastrointestinal risk, and ibuprofen may also interfere with aspirin’s intended antiplatelet effect. Atorvastatin is relevant to some dental prescriptions, particularly interacting macrolides, but it is not the principal reason to avoid ibuprofen here. Ramipril may be adversely affected by NSAIDs in some patients, particularly regarding renal function and blood-pressure control, but the discriminating stem feature is aspirin antiplatelet therapy. Therefore, aspirin is the single best answer.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP), Dental Companion. “Interactions with drugs prescribed by dentists”, accessed July 2026. https://companion.sdcep.org.uk/management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs/flowcharts-and-tools/interactions-with-drugs-prescribed-by-dentists/