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Topical NSAID advice — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsTopical NSAID adviceGPhC CRA

A patient with localised hand osteoarthritis asks for pain relief. They have a history of peptic ulcer bleeding and take apixaban. What is the most appropriate alternative?

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

Topical NSAIDs may provide local relief with lower systemic exposure than oral NSAIDs, although caution and counselling are still needed. Oral NSAIDs would increase gastrointestinal and bleeding risk, particularly with apixaban and previous ulcer bleeding. Aspirin would further increase bleeding risk. Colchicine is not a treatment for osteoarthritis pain.

Reference: NICE CKS; BNF