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NSAID topical versus oral safety — GPhC CRA MCQ

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EasyMusculoskeletal TherapeuticsNSAID topical versus oral safetyGPhC CRA

A 60-year-old woman with hand osteoarthritis asks for pain relief. She takes apixaban and had dyspepsia with oral ibuprofen. What is the most appropriate alternative?

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

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Correct answer: D — Consider topical NSAID with counselling and bleeding-risk awareness

Topical NSAIDs can be useful for localised osteoarthritis pain and have lower systemic exposure than oral NSAIDs. Oral NSAIDs with apixaban would increase bleeding risk and should generally be avoided unless clinically directed. Aspirin also increases bleeding risk. Non-drug measures and paracetamol may also be discussed depending on symptoms.

Reference: BNF; NICE CKS