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NSAIDs in CKD — GPhC CRA MCQ

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EasyRenal and Hepatic ImpairmentNSAIDs in CKDGPhC CRA

A 77-year-old woman with CKD stage 4 asks for ibuprofen tablets for back pain. She takes lisinopril and furosemide. Her latest eGFR is 24mL/min/1.73m2. What is the most appropriate alternative?

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Correct answer: A — Advise against oral NSAIDs and discuss safer analgesia or referral

Oral NSAIDs can worsen renal function and increase acute kidney injury risk, especially with ACE inhibitors and diuretics. In CKD stage 4, safer analgesic options and clinical assessment should be considered. The pharmacist should also screen for back pain red flags.

Reference: BNF; NICE CKS