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Lithium and NSAID interaction — GPhC CRA MCQ

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HardDrug InteractionsLithium and NSAID interactionGPhC CRA

A 69-year-old woman takes lithium carbonate, ramipril and bendroflumethiazide. She asks to buy ibuprofen for shoulder pain. Her latest lithium level was within range and eGFR is 54mL/min/1.73m2. What is the most important interaction to flag?

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

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Correct answer: E — Ibuprofen can increase lithium concentration and toxicity risk.

NSAIDs can reduce renal lithium clearance and increase lithium concentrations. This patient also takes an ACE inhibitor and thiazide, adding renal and lithium-toxicity risk. The pharmacist should avoid OTC ibuprofen supply and advise prescriber review for analgesia.

Reference: BNF