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NSAID renal risk triple whammy — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsNSAID renal risk triple whammyGPhC CRA

A patient taking ramipril and bendroflumethiazide asks to buy ibuprofen for back pain after a dehydrating illness. His latest eGFR is 42mL/min/1.73m2. What is the most important interaction to flag?

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Correct answer: C — Ibuprofen with ACE inhibitor and diuretic can increase acute kidney injury risk

NSAIDs combined with an ACE inhibitor or ARB and a diuretic can increase risk of acute kidney injury, especially with dehydration or chronic kidney disease. The pharmacist should avoid recommending ibuprofen and advise safer pain relief and hydration or medical review. This is a clinically significant interaction to flag.

Reference: BNF; NICE CKS