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Heart failure and NSAIDs — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHeart failure and NSAIDsGPhC CRA

A 72-year-old man with heart failure takes bisoprolol, ramipril and furosemide. He asks to buy ibuprofen for knee pain after gardening. What is the most appropriate action?

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

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Correct answer: A — Decline ibuprofen and suggest paracetamol with referral if pain persists

NSAIDs can worsen heart failure, reduce renal perfusion, and antagonise diuretic and antihypertensive therapy. This patient is already on medicines that increase renal vulnerability. Paracetamol is a safer first option for short-term musculoskeletal pain, with referral if symptoms persist or red flags develop. Extra fluids or diuretic self-adjustment would not make OTC NSAID supply appropriate.

Reference: BNF; NICE CKS