A 54-year-old man with decompensated cirrhosis asks to buy co-codamol for back pain. He drinks no alcohol now, has ascites and his recent INR is 1.6.

Question

A 54-year-old man with decompensated cirrhosis asks to buy co-codamol for back pain. He drinks no alcohol now, has ascites and his recent INR is 1.6. He already takes prescribed paracetamol 1g four times daily. What is the most appropriate action?

Accepted Answer

Do not supply co-codamol and refer for analgesia review because he is already at maximum paracetamol exposure.

Answer

Supply co-codamol and advise taking it in addition to current paracetamol.

Answer

Recommend ibuprofen because cirrhosis prevents paracetamol toxicity.

Answer

Supply aspirin because raised INR protects against thrombosis.

Answer

Advise doubling prescribed paracetamol for three days.

Paracetamol duplication in cirrhosis — GPhC CRA MCQ

A 54-year-old man with decompensated cirrhosis asks to buy co-codamol for back pain. He drinks no alcohol now, has ascites and his recent INR is 1.6. He already takes prescribed paracetamol 1g four times daily. What is the most appropriate action?