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NSAID triple whammy — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsNSAID triple whammyGPhC CRA

A patient taking ramipril and furosemide asks to buy naproxen for back pain. Their last eGFR was 45 mL/min/1.73 m². What is the most appropriate action?

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Correct answer: B — Avoid OTC NSAID supply and discuss safer analgesia or prescriber review

NSAIDs combined with an ACE inhibitor and diuretic increase the risk of acute kidney injury, particularly in CKD. OTC NSAID supply is not appropriate without clinical review. Stopping established cardiovascular medicines without prescriber input is unsafe. Combining NSAIDs further increases toxicity.

Reference: BNF; NICE CKS