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Macrogol in renal impairment — GPhC CRA MCQ

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EasyRenal and Hepatic ImpairmentMacrogol in renal impairmentGPhC CRA

A 70-year-old woman with CKD stage 4 asks for constipation treatment. She has hard stools, no vomiting and is not fluid-restricted. She asks whether magnesium salts are safe. What is the most appropriate alternative?

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Correct answer: D — Use a non-magnesium laxative such as macrogol if suitable

Magnesium-containing laxatives can accumulate in significant renal impairment and should be used cautiously or avoided. Macrogol is often a safer osmotic option if the patient can take the required fluid and has no obstruction. Phosphate products also require caution in renal impairment. Loperamide worsens constipation.

Reference: BNF; NICE CKS