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DOAC bleeding risk with NSAID — GPhC CRA MCQ

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HardCardiovascular TherapeuticsDOAC bleeding risk with NSAIDGPhC CRA

A woman taking edoxaban has extensive bruising and a haemoglobin fall from 128 to 104 g/L. A new prescription requests naproxen 500 mg twice daily. What should the pharmacist do?

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

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Correct answer: BDo not supply naproxen and arrange urgent bleeding assessment

The haemoglobin fall and bruising may represent clinically important bleeding. An NSAID would further increase gastrointestinal and other bleeding risk with edoxaban; gastroprotection does not remove that risk. The patient needs urgent assessment and prescriber-led analgesic and anticoagulant decisions.

Reference: BNF: edoxaban: https://bnf.nice.org.uk/drugs/edoxaban/