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DOAC and NSAID interaction — GPhC CRA MCQ

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HardDrug InteractionsDOAC and NSAID interactionGPhC CRA

A 69-year-old man with non-valvular atrial fibrillation collects apixaban 5 mg twice daily. He has started taking ibuprofen 400 mg three times daily for knee pain bought from a supermarket. He also takes bisoprolol and atorvastatin. What is the most important interaction to flag?

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Correct answer: E — Apixaban with ibuprofen increases bleeding risk

Concomitant NSAID and DOAC use increases gastrointestinal and other bleeding risk. Ibuprofen should generally be avoided or used with prescriber advice, gastroprotection and a clear indication. Safer analgesia such as paracetamol should be considered while ensuring the knee pain is assessed if persistent or inflammatory.

Reference: BNF