Name a condition that makes NSAIDs less suitable for OTC use.

• A. Seasonal allergies
• B. Diabetes with complications
• C. Controlled hypertension
• D. History of ulcers/GI bleeding or kidney disease

Answer: (D)

NSAIDs work by blocking enzymes that make prostaglandins, which reduces pain and inflammation but also lowers protective prostaglandins in the stomach and kidneys. That’s why they’re risky for people with a history of ulcers or GI bleeding or with kidney disease. In those individuals, taking NSAIDs can worsen gastric ulcers, cause bleeding, or precipitate kidney injury, which is why these conditions make NSAIDs less suitable for over-the-counter use.

Other listed conditions aren’t as direct a red flag. Seasonal allergies aren’t a primary contraindication, diabetes with complications isn’t automatically a stopping point unless kidney involvement is present, and controlled hypertension may be managed with caution but isn’t as clear a contraindication as GI ulcers or kidney disease.