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Thiazide and gout — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsThiazide and goutGPhC CRA

A 66-year-old man with hypertension and gout is prescribed bendroflumethiazide 2.5mg daily. He has had three gout attacks this year and serum urate remains high despite lifestyle measures. What is the most appropriate action?

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Correct answer: E — Query the choice because thiazide diuretics can worsen hyperuricaemia and gout

Thiazide and thiazide-like diuretics can increase urate and precipitate gout. In a patient with frequent gout attacks, antihypertensive choice should be reviewed by the prescriber. Aspirin is not a gout-prevention strategy and may affect urate handling depending on dose. Pharmacists should not independently switch prescribed antihypertensives.

Reference: BNF; NICE CKS Gout