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NSAID use with anticoagulant — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsNSAID use with anticoagulantGPhC CRA

A 61-year-old man taking apixaban for atrial fibrillation asks to buy ibuprofen tablets for acute knee pain after gardening. He has a history of dyspepsia and takes ramipril. What would you advise the patient?

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

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Correct answer: B — Avoid oral ibuprofen and discuss safer analgesic options

Oral NSAIDs increase bleeding risk with anticoagulants and can worsen renal function, particularly with ACE inhibitors and older age. Dyspepsia adds further gastrointestinal risk. The safest pharmacy action is to avoid OTC oral ibuprofen and consider alternatives such as paracetamol, topical treatment, or referral depending on severity.

Reference: BNF; NICE CKS