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Acute gout with anticoagulation — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsAcute gout with anticoagulationGPhC CRA

A patient presents a prescription for naproxen 500mg twice daily for acute gout. He takes apixaban for AF, has eGFR 34mL/min/1.73m2 and had a peptic ulcer bleed last year. What is the most appropriate alternative?

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Correct answer: D — Contact prescriber for non-NSAID flare treatment

Systemic NSAIDs are high risk here because of anticoagulation, CKD and previous ulcer bleeding. Acute gout can often be treated with colchicine or a corticosteroid depending on patient factors, so the prescriber should review. Giving naproxen with food is insufficient risk mitigation. Aspirin and another NSAID would not address the safety problem.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment