Warfarin counselling — GPhC CRA MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: E — Decline ibuprofen and choose an alternative analgesic with concurrent warfarin
Decline ibuprofen and choose an alternative analgesic with concurrent warfarin: NSAIDs increase gastrointestinal and other bleeding risk independently of INR; paracetamol is usually safer, although regular higher-dose use can also affect anticoagulation. Use low-dose ibuprofen while the INR remains within target and add proton-pump-inhibitor gastroprotection: A therapeutic INR does not prevent NSAID-related platelet and gastrointestinal bleeding. Use ibuprofen at least six hours after each warfarin dose: Separating administration does not remove the pharmacodynamic bleeding risk. Pause warfarin on each day that ibuprofen treatment is needed: Unsupervised anticoagulant interruption risks recurrent thrombosis. Use aspirin temporarily in place of warfarin during ibuprofen treatment: Aspirin does not provide equivalent VTE treatment and further increases bleeding risk.
Reference: BNF: warfarin sodium: https://bnf.nice.org.uk/drugs/warfarin-sodium/