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Heart failure fluid retention — GPhC CRA MCQ

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HardCardiovascular TherapeuticsHeart failure fluid retentionGPhC CRA

A 78-year-old man with heart failure with reduced ejection fraction collects ibuprofen 400mg tablets bought from another pharmacy for knee pain. He takes furosemide 40mg daily, ramipril 5mg daily and bisoprolol 5mg daily. He has gained 2kg over 5 days and reports ankle swelling and increasing breathlessness. 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: A — Ibuprofen may worsen heart failure and reduce diuretic effect

NSAIDs can worsen heart failure, promote fluid retention, reduce renal perfusion and blunt diuretic effect. The patient already has weight gain, ankle swelling and increasing breathlessness, suggesting possible decompensation. The pharmacist should advise against ibuprofen and arrange prompt clinical review. Gastroprotection would not mitigate the heart failure and renal risks.

Reference: BNF; NICE CKS Heart failure