The quickest way to learn how the Saudi Pharmacist Licensure Examination asks things is to answer questions in its style. Below is a short recap of the SPLE pattern as the Saudi Commission for Health Specialties (SCFHS) publishes it, then 15 practice questions across the four blueprint domains with worked answers. For a longer run of items sorted by domain, the Myndaq SPLE course is built on the same blueprint.
All 15 are original practice questions written by our editors, not official or past-paper SPLE items. Prometric, which delivers the test, says anyone claiming to offer official test content is unauthorised.
The SPLE pattern in brief
The SCFHS SPLE Examination Content Guideline (the applicant guide PDF that SCFHS posted in September 2025) describes the paper this way:
- 200 computer-based questions in two parts of 100
- 120 minutes per part, with a scheduled 30-minute break
- Four options per question; you choose the best answer
- Up to 10% pilot questions, so treat every item as live
- 536 to pass, on a reporting scale of 200 to 800
- Results announced within 2 to 6 weeks of the end of the test window
Prometric lists the SPLE duration as 4 hours 30 minutes from 1 March 2023. The guide says the paper mixes recall questions with scenario questions that test interpretation, analysis, decision-making, reasoning and problem-solving; each item below is tagged recall, scenario or calculation.
The published blueprint weights are Pharmaceutical Sciences 35%, Clinical Sciences 35%, Social, Behavioral and Administrative Sciences 20% and Basic Biomedical Sciences 10%, and SCFHS adds that the distribution on any given paper may differ by up to plus or minus 5% at each level. What each domain contains is in the SPLE blueprint explained; this set follows roughly the same proportions. Allow about 72 seconds a question.
Basic Biomedical Sciences questions
Question 1
Scenario. A patient develops haemolytic anaemia a few days after starting an oxidant drug, and tests show an inherited enzyme deficiency. Which enzyme is most likely deficient?
- A. Glucose-6-phosphate dehydrogenase
- B. Thiopurine S-methyltransferase
- C. Hypoxanthine-guanine phosphoribosyltransferase
- D. Pyruvate kinase
Answer: A. G6PD drives the pentose phosphate pathway, the red cell's main source of NADPH, which keeps glutathione reduced; without it, oxidant drugs damage red cells. TPMT deficiency causes thiopurine marrow toxicity, HGPRT deficiency causes Lesch-Nyhan syndrome, and pyruvate kinase deficiency causes chronic haemolysis that is not drug-triggered.
Question 2
Recall. A sputum culture grows Gram-positive cocci in clusters that are catalase-positive and coagulase-positive. Which organism is this?
- A. Streptococcus pyogenes
- B. Staphylococcus epidermidis
- C. Staphylococcus aureus
- D. Enterococcus faecalis
Answer: C. Clusters suggest staphylococci, and catalase separates them from catalase-negative streptococci and enterococci. Coagulase then separates Staphylococcus aureus from coagulase-negative species such as S. epidermidis.
Pharmaceutical Sciences questions
Question 3
Calculation. A 70 kg adult needs an intravenous loading dose to reach a plasma concentration of 15 mg/L. The volume of distribution is 0.7 L/kg. What dose is needed?
- A. 490 mg
- B. 735 mg
- C. 1,050 mg
- D. 1,470 mg
Answer: B. Loading dose = target concentration × volume of distribution (bioavailability is 1 intravenously). The volume is 0.7 × 70 = 49 L, so the dose is 15 × 49 = 735 mg. Option C forgets the 0.7.
Question 4
Calculation. An infusion bag holds 1 g of a drug in 250 mL. The order is 2 mg/min. At what rate should the pump run?
- A. 7.5 mL/h
- B. 15 mL/h
- C. 30 mL/h
- D. 60 mL/h
Answer: C. The concentration is 1,000 mg ÷ 250 mL = 4 mg/mL. The dose is 2 mg/min × 60 = 120 mg/h, and 120 mg/h ÷ 4 mg/mL = 30 mL/h.
Question 5
Calculation. A weakly acidic drug with a pKa of 4.4 is in gastric fluid at pH 1.4. What is the approximate ratio of ionised to un-ionised drug?
- A. 1,000:1
- B. 1:1
- C. 1:1,000
- D. 3:1
Answer: C. For a weak acid, log (ionised ÷ un-ionised) = pH − pKa = 1.4 − 4.4 = −3, so the ratio is 1:1,000. A weak acid stays mostly un-ionised in acid, which favours passive diffusion. Option A would suit a weak base.
Question 6
Recall. Magnesium stearate is added to a tablet formulation mainly as which of these?
- A. Binder
- B. Disintegrant
- C. Lubricant
- D. Diluent
Answer: C. Magnesium stearate reduces friction between tablet and die wall during compression and ejection. Because it is hydrophobic, excess or over-mixing can slow dissolution. Binders hold granules together, disintegrants break tablets apart, and diluents add bulk.
Question 7
Scenario. An adult arrives several hours after a large paracetamol overdose, and the plasma level is above the treatment line. Which antidote is indicated?
- A. Flumazenil
- B. Naloxone
- C. Acetylcysteine
- D. Fomepizole
Answer: C. In overdose, conjugation saturates and more paracetamol becomes the toxic metabolite NAPQI, normally neutralised by glutathione. Acetylcysteine replenishes glutathione and works best started early. Flumazenil reverses benzodiazepines, naloxone reverses opioids, and fomepizole treats methanol and ethylene glycol poisoning.
Social, Behavioral and Administrative Sciences questions
These items test general principles; the blueprint also covers pharmacy law and regulatory affairs in this domain, so use current official texts for those.
Question 8
Calculation. In a five-year trial, stroke occurred in 10% of patients on placebo and 6% of patients on a new drug. How many patients must be treated for five years to prevent one stroke?
- A. 4
- B. 17
- C. 25
- D. 40
Answer: C. The absolute risk reduction is 10% − 6% = 4%, or 0.04, and the number needed to treat is 1 ÷ 0.04 = 25. Option D confuses it with the relative risk reduction of 40%.
Question 9
Scenario. A technician picks a look-alike vial from the wrong shelf, but the pharmacist spots the error at the final check, before anything reaches the patient. How is this event best classified?
- A. Adverse drug reaction
- B. Near miss
- C. Medication error that reached the patient without harm
- D. Sentinel event
Answer: B. A near miss is an error caught before it reaches the patient, so option C is wrong, and an adverse drug reaction is harm from a drug used as intended. Near misses should still be reported.
Question 10
Recall. A hospital compares two drugs by cost per quality-adjusted life year (QALY) gained. Which type of economic evaluation is this?
- A. Cost-minimisation analysis
- B. Cost-effectiveness analysis
- C. Cost-utility analysis
- D. Cost-benefit analysis
Answer: C. Cost-utility analysis measures outcomes in QALYs, which combine length and quality of life. Cost-minimisation assumes equal outcomes, cost-effectiveness uses natural units such as life-years, and cost-benefit values outcomes in money.
Clinical Sciences questions
Question 11
Calculation. A 70-year-old man weighing 60 kg has a serum creatinine of 1.2 mg/dL. Using the Cockcroft-Gault equation, what is his estimated creatinine clearance?
- A. 41 mL/min
- B. 49 mL/min
- C. 58 mL/min
- D. 70 mL/min
Answer: B. Clearance = (140 − age) × weight ÷ (72 × serum creatinine) = (70 × 60) ÷ (72 × 1.2) = 4,200 ÷ 86.4, about 49 mL/min. Option A applies the 0.85 factor used for women.
Question 12
Scenario. A patient taking simvastatin 40 mg daily is prescribed clarithromycin for a chest infection. What is the most appropriate action?
- A. Continue both drugs unchanged
- B. Withhold simvastatin for the duration of the clarithromycin course
- C. Double the simvastatin dose to keep lipids controlled
- D. Replace clarithromycin with erythromycin and continue simvastatin
Answer: B. Clarithromycin strongly inhibits CYP3A4, the main route of simvastatin metabolism, so statin levels rise along with the risk of myopathy and rhabdomyolysis. Pausing the statin for a short course carries little risk, and erythromycin also inhibits CYP3A4.
Question 13
Scenario. A woman at 20 weeks of pregnancy has hypertension that needs treatment. Which drug should be avoided?
- A. Methyldopa
- B. Labetalol
- C. Nifedipine
- D. Lisinopril
Answer: D. ACE inhibitors such as lisinopril can harm the fetus, including its kidneys, especially in the second and third trimesters. Labetalol, nifedipine and methyldopa are established choices in pregnancy.
Question 14
Scenario. A 62-year-old man with type 2 diabetes has taken metformin for years. His eGFR is now 25 mL/min/1.73 m². What should the pharmacist recommend?
- A. Continue metformin at the same dose
- B. Halve the metformin dose
- C. Stop metformin and review the glucose-lowering plan
- D. Switch to extended-release metformin
Answer: C. Metformin is cleared by the kidneys, and below an eGFR of 30 it is contraindicated because accumulation raises the risk of lactic acidosis. Dose reduction suits moderate impairment, not this level, and an extended-release form is still metformin.
Question 15
Scenario. A patient collecting a first prescription for once-weekly alendronate asks how to take it. Which advice is correct?
- A. Take it with breakfast and a glass of milk
- B. Take it at bedtime so it works overnight
- C. Take it on waking with plain water, before food, and stay upright
- D. Take it with orange juice to help absorption
Answer: C. Take it on waking with a full glass of plain water, at least 30 minutes before food, drink or other medicines, and stay upright for at least 30 minutes and until after the first food of the day. Food, milk and juice cut its poor absorption, and staying upright protects the oesophagus.
Official practice tests
The applicant guide says you can apply on the SCFHS website for an SPLE practice test sampled from the SPLE item bank. SCFHS has a Practice Exam for Saudi Licensure Examinations page, and Prometric says these practice exams can be taken remotely through ProProctor, with the score report emailed within 24 hours. We found no practice-test fee or length on either page on 16 September 2026, so check them when you book.
Quick answers
Are these real SPLE exam questions?
No. All 15 are original practice questions in the SPLE's four-option style, not official or past-paper items.
Does SCFHS offer an official practice test?
Yes. The applicant guide points to an SPLE practice test on the SCFHS website, and Prometric lists remote practice exams for the Saudi licensure titles.
What score do I need to pass the SPLE?
536 on a 200 to 800 reporting scale. It is a scaled score, not a percentage, as what a 536 actually means explains.
