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Heart failure NSAID risk — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHeart failure NSAID riskGPhC CRA

A 76-year-old man with heart failure takes ramipril, bisoprolol and furosemide. He asks for ibuprofen tablets for knee pain after gardening. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Avoid ibuprofen and suggest paracetamol or referral for safer analgesia

NSAIDs can worsen heart failure, antagonise diuretics and increase renal risk, particularly with ACE inhibitors and diuretics. Paracetamol or non-pharmacological measures are safer initial options. Referral is appropriate if pain is severe or persistent.

Reference: BNF; NICE CKS