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Gout acute treatment contraindication — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsGout acute treatment contraindicationGPhC CRA

A 69-year-old man with acute gout has CKD stage 4 and a history of peptic ulcer bleeding. He asks for naproxen because it worked for his friend. What is the most appropriate alternative?

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Correct answer: E — Refer for prescriber assessment of suitable acute gout treatment

NSAIDs are often unsuitable in advanced CKD and previous ulcer bleeding. Acute gout options need individual assessment, and corticosteroids or adjusted colchicine may be considered by a prescriber depending on risks. Aspirin can worsen gout and increases bleeding risk. Starting high-dose allopurinol during an unmanaged flare is inappropriate.

Reference: NICE CKS; BNF