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NSAID in CKD — GPhC CRA MCQ

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EasyRenal and Hepatic ImpairmentNSAID in CKDGPhC CRA

A 79-year-old patient with CKD stage 4 asks to buy ibuprofen for shoulder pain. They take ramipril and furosemide. What is the most appropriate alternative?

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

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Correct answer: E — Do not supply ibuprofen and advise safer analgesia or clinical review

NSAIDs can worsen renal function and precipitate AKI, especially in advanced CKD and with ACE inhibitors and diuretics. OTC status does not mean the medicine is suitable. The pharmacist should advise safer options and clinical review. Extra diuretic or reduced fluids may worsen renal risk.

Reference: BNF; NICE CKS