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ACE inhibitor and NSAID — GPhC CRA MCQ

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ModerateDrug InteractionsACE inhibitor and NSAIDGPhC CRA

A 74-year-old woman takes ramipril and bendroflumethiazide for hypertension. She asks to buy ibuprofen tablets for a sprained wrist after reduced fluid intake during a heatwave. What is the most important interaction to flag?

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Correct answer: B — Ibuprofen may increase acute kidney injury risk with ramipril and diuretic therapy

NSAIDs can reduce renal perfusion, particularly during dehydration. Combined with an ACE inhibitor and diuretic, the risk of acute kidney injury is increased. Older age and recent poor intake further increase risk. The pharmacist should recommend safer analgesia and hydration advice or referral.

Reference: BNF