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NSAIDs in cirrhosis — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentNSAIDs in cirrhosisGPhC CRA

A 70-year-old man with cirrhosis and ascites asks to buy naproxen for shoulder pain. He takes spironolactone and furosemide and has had a previous variceal bleed. What is the most appropriate alternative?

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Correct answer: A — Advise against NSAIDs and refer for suitable analgesia advice

NSAIDs are generally avoided in cirrhosis with ascites because they can worsen renal function, fluid retention and bleeding risk. This patient has a history of variceal bleeding and is on diuretics, increasing risk. Analgesia should be discussed with a clinician familiar with his liver disease.

Reference: BNF; NICE CKS