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NSAID triple whammy — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsNSAID triple whammyGPhC CRA

A 71-year-old man taking ramipril and bendroflumethiazide asks to buy ibuprofen for knee pain. His eGFR last month was 46 mL/min/1.73 m2. He has no acute injury. What is the most important interaction to flag?

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Correct answer: CIbuprofen with ACE inhibitor and diuretic increases acute kidney injury risk

NSAIDs combined with ACE inhibitors or ARBs and diuretics increase the risk of acute kidney injury. Existing chronic kidney disease increases the concern. The patient should be advised against self-treatment with ibuprofen and offered safer options or referral.

Reference: BNF; NICE CKS