A 43-year-old regular patient with shoulder pain on Ramipril 10 mg and Amlodipine 5 mg asks for an OTC analgesic. Which option is most appropriate?

A 43-year-old regular patient with shoulder pain on Ramipril 10 mg and Amlodipine 5 mg asks for an OTC analgesic. Which option is most appropriate?

• A. Paracetamol caplets
• B. Ibuprofen
• C. Diclofenac
• D. Aspirin

Answer: (A)

When choosing an OTC analgesic for someone with hypertension treated with Ramipril and Amlodipine, safety for blood pressure, kidney function, and the GI tract is the priority. Paracetamol provides effective pain relief without impacting blood pressure, risking kidney perfusion, or causing sodium/fluid retention. NSAIDs like ibuprofen or diclofenac can raise blood pressure, reduce the antihypertensive effects of ACE inhibitors, and impair kidney function, especially with ongoing antihypertensive therapy. Aspirin also carries a higher risk of GI bleeding with regular OTC use. So paracetamol is the best option for this patient, with usual cautions about liver disease or heavy alcohol use and not exceeding the recommended dose.

When choosing an OTC analgesic for someone with hypertension treated with Ramipril and Amlodipine, safety for blood pressure, kidney function, and the GI tract is the priority. Paracetamol provides effective pain relief without impacting blood pressure, risking kidney perfusion, or causing sodium/fluid retention. NSAIDs like ibuprofen or diclofenac can raise blood pressure, reduce the antihypertensive effects of ACE inhibitors, and impair kidney function, especially with ongoing antihypertensive therapy. Aspirin also carries a higher risk of GI bleeding with regular OTC use. So paracetamol is the best option for this patient, with usual cautions about liver disease or heavy alcohol use and not exceeding the recommended dose.