Macrogol electrolyte renal caution — GPhC CRA MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: D — Delay treatment, correct calcium and plan enhanced post-dose monitoring
Pre-existing hypocalcaemia is a contraindication to denosumab 60 mg and must be corrected before treatment. Severe renal impairment does not require a reduced denosumab dose, but it materially increases the risk of severe symptomatic hypocalcaemia and therefore supports calcium/vitamin D optimisation and post-dose calcium monitoring. Immediate antacid use and unreviewed zoledronate substitution do not solve the risk.
Reference: MHRA: denosumab calcium monitoring. https://www.gov.uk/drug-safety-update/denosumab-monitoring-recommended