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Acute gout with anticoagulation and CKD — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsAcute gout with anticoagulation and CKDGPhC CRA

A 70-year-old man with acute gout asks to buy ibuprofen. He takes apixaban for AF, ramipril for hypertension and has eGFR 42 mL/min/1.73 m2. What is the most appropriate alternative?

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Correct answer: A — Refer for colchicine or corticosteroid assessment

NSAIDs are high risk because he takes a DOAC, has CKD and is on an ACE inhibitor. Acute gout still needs treatment, but colchicine or corticosteroid options should be assessed with renal function, interactions and comorbidities in mind. Gastroprotection alone would not address bleeding and renal risks.

Reference: BNF; NICE CKS