Which risk increases when diclofenac is given with warfarin?

Which risk increases when diclofenac is given with warfarin?

• A. Hypertension
• B. Hypoglycemia
• C. Bleeding risk
• D. Hyperkalemia

Answer: (C)

This question hinges on how NSAIDs interact with an anticoagulant to affect bleeding risk. Diclofenac, an NSAID, can irritate the stomach lining and impair platelet function, while warfarin lowers the body’s ability to form clots by reducing vitamin K–dependent clotting factors. Put together, these effects make it easier for bleeding to occur and harder to control once it starts, especially in the GI tract. There may also be a pharmacokinetic tinge to the interaction, such as a modest increase in free warfarin levels due to competition for protein binding, but the most important consequence is the amplified bleeding risk. Other listed risks aren’t typically tied to this drug combination in the same strong way.

This question hinges on how NSAIDs interact with an anticoagulant to affect bleeding risk. Diclofenac, an NSAID, can irritate the stomach lining and impair platelet function, while warfarin lowers the body’s ability to form clots by reducing vitamin K–dependent clotting factors. Put together, these effects make it easier for bleeding to occur and harder to control once it starts, especially in the GI tract. There may also be a pharmacokinetic tinge to the interaction, such as a modest increase in free warfarin levels due to competition for protein binding, but the most important consequence is the amplified bleeding risk. Other listed risks aren’t typically tied to this drug combination in the same strong way.