Dapagliflozin sick day — GPhC CRA MCQ
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Correct answer: A — Query meropenem urgently because carbapenems rapidly lower valproate and the interaction is not manageable
Option A is correct: carbapenems can lower valproate concentrations by 60–100% in about two days, with breakthrough convulsions, and the rapid interaction is not considered manageable by routine dose adjustment. Option D changes route but not the interaction. Option B understates both speed and magnitude. Option E invents a gut-only interaction. Option C adds treatment without resolving the interacting antimicrobial and requires specialist seizure-management decisions.
Reference: Meropenem SmPC: https://www.medicines.org.uk/emc/product/9074/smpc