NSAID Contraindications — MFDS Part 1 MCQ

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EasyPharmacologyNSAID ContraindicationsMFDS Part 1

A dentist is considering a short course of ibuprofen for acute dental pain. Which history most clearly requires caution because it increases the risk of gastrointestinal ulceration or bleeding?

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Correct answer: C — A single previous episode of peptic ulcer disease, now healed

Explanation lettering: E = shown as A · D = shown as B · A = shown as C · B = shown as D · C = shown as E

A is correct. Ibuprofen and other NSAIDs reduce protective gastrointestinal prostaglandin synthesis and can cause ulceration, bleeding or perforation. A previous peptic ulcer increases this risk, so ibuprofen requires careful risk assessment and, if used, the lowest effective dose for the shortest duration. Active peptic ulcer disease or recurrent ulceration or haemorrhage—two or more proven episodes—is a contraindication rather than merely a caution. Penicillin allergy is unrelated to ibuprofen. Epilepsy and hypothyroidism are not, by themselves, standard contraindications or gastrointestinal risk factors for ibuprofen. Well-controlled type 2 diabetes alone does not create the specific gastrointestinal risk tested here; cardiovascular risk requires greater consideration particularly with long-term, high-dose ibuprofen.

Reference: Electronic Medicines Compendium, Ibuprofen 200 mg film-coated tablets, Summary of Product Characteristics, sections 4.3 and 4.4, text revised 26 June 2026. https://www.medicines.org.uk/emc/product/11166/smpc