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NSAID CKD — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentNSAID CKDGPhC CRA

A prescriber is considering oral diclofenac for musculoskeletal pain. Which history makes systemic diclofenac specifically contraindicated under MHRA cardiovascular advice?

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Correct answer: D — Established ischaemic heart disease

Systemic diclofenac is contraindicated in established ischaemic heart disease, peripheral arterial disease, cerebrovascular disease and NYHA class II–IV congestive heart failure. Hypertension, diabetes, hyperlipidaemia and smoking are important cardiovascular risk factors requiring careful benefit–risk consideration, but they are not individually the listed established-disease contraindication.

Reference: MHRA Drug Safety Update, Diclofenac—new contraindications and warnings: https://www.gov.uk/drug-safety-update/diclofenac-new-contraindications-and-warnings