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NSAID use in heart failure — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentNSAID use in heart failureGPhC CRA

A 74-year-old man brings a new prescription for ibuprofen 400mg three times daily for knee pain. His repeat medicines include ramipril 10mg daily, furosemide 40mg daily and spironolactone 25mg daily for heart failure. He says his ankles have been more swollen this week. 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: C — Ibuprofen can worsen renal function and fluid retention with his current medicines

NSAIDs can worsen fluid retention and renal function in heart failure, and the combination with an ACE inhibitor and diuretics increases acute kidney injury risk. The swollen ankles add a clinical safety concern rather than a routine pain query. A pharmacist should withhold supply and discuss a safer analgesic plan with the prescriber.

Reference: BNF; NICE CKS