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Lithium and NSAIDs — GPhC CRA MCQ

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HardDrug InteractionsLithium and NSAIDsGPhC CRA

A patient stabilised on lithium asks to buy ibuprofen for a sprained ankle. His most recent lithium level was within range. He has no current renal test result with him. What is the most important interaction to flag?

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Correct answer: C — Ibuprofen can increase lithium concentration and toxicity risk

NSAIDs can reduce renal lithium clearance, increasing lithium concentrations and toxicity risk. Symptoms such as tremor, confusion, diarrhoea or ataxia require urgent assessment. A recent therapeutic level does not remove risk after adding an NSAID. A safer analgesic approach or prescriber advice should be considered.

Reference: BNF