Which combination would be a red flag for NSAID use in a patient with chronic pain?

• A. History of NSAID hypersensitivity.
• B. Young age and no comorbidities.
• C. Use of acetaminophen only.
• D. Well-controlled hypertension.

Answer: (B)

NSAIDs carry risks that can turn them into unsafe choices for certain patients. A red flag means a condition or history that would make using NSAIDs inappropriate or require extra caution, monitoring, or an alternative plan. The strongest red flag among the options is a history of hypersensitivity to NSAIDs; if a patient has reacted to NSAIDs before, re-exposure could trigger a severe reaction and NSAIDs should be avoided.

Young age with no comorbidities is not a red flag; in fact, it generally lowers risk because fewer health issues mean fewer factors that could be worsened by NSAID use. Using acetaminophen only indicates the patient isn’t using NSAIDs at all, which is not a red flag for NSAID safety—it's a different approach to pain management. Well-controlled hypertension isn’t an absolute red flag on its own; NSAIDs can raise blood pressure or affect kidney function, but if the hypertension is well managed and there aren't other risk factors, it’s not by itself a contraindication.