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Heart failure NSAID avoidance — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsHeart failure NSAID avoidanceGPhC CRA

A patient with heart failure taking ramipril, bisoprolol, spironolactone and furosemide asks to buy ibuprofen for knee pain. Their ankles have been more swollen this week. What is the most important interaction to flag?

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

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Correct answer: A — Avoid ibuprofen and discuss safer analgesia options

NSAIDs can worsen heart failure, reduce renal perfusion and increase the risk of renal impairment, especially with ACE inhibitors and diuretics. The ankle swelling makes this request higher risk. A safer analgesic plan and clinical review should be considered. Stopping diuretics or adding salt would worsen the clinical risk.

Reference: BNF; NICE CKS