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Topical NSAID counselling — GPhC CRA MCQ

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EasyMusculoskeletal TherapeuticsTopical NSAID counsellingGPhC CRA

A patient buys diclofenac gel for knee osteoarthritis. He takes warfarin and asks whether the gel is safer than tablets. His INR has been stable. What is the most appropriate alternative?

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

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Correct answer: C — Use the gel as directed and avoid applying to broken skin

Topical NSAIDs have lower systemic exposure than oral NSAIDs but still require appropriate use. The gel should be applied as directed to intact skin and hands washed after application. Combining with oral ibuprofen increases bleeding and gastrointestinal risks. Warfarin should not be stopped without prescriber advice.

Reference: BNF; NICE CKS