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NSAID bleeding risk — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsNSAID bleeding riskGPhC CRA

A 69-year-old man with osteoarthritis asks to buy ibuprofen tablets. He takes apixaban for AF and has a previous duodenal ulcer; his eGFR is 48mL/min/1.73m2. What is the most appropriate alternative?

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Correct answer: B — Recommend non-NSAID analgesia and refer for review of pain control

Oral NSAIDs increase gastrointestinal bleeding risk, and the risk is higher with anticoagulants and previous ulcer disease. Renal impairment adds further caution. Non-NSAID options and prescriber review are safer than OTC ibuprofen supply. Stopping apixaban without prescriber advice would expose the patient to stroke risk.

Reference: BNF; NICE CKS NSAIDs prescribing issues