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Impetigo management — GPhC CRA MCQ

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HardInfectionsImpetigo managementGPhC CRA

A patient with opioid-induced constipation is prescribed naloxegol 25 mg daily. Before dispensing, the pharmacist sees a new 7-day prescription for clarithromycin. What should happen?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Withhold naloxegol and ask the prescriber to review clarithromycin

Explanation lettering: E = shown as A · D = shown as B · B = shown as D · A = shown as E

A is correct: clarithromycin is a strong CYP3A4 inhibitor and can markedly increase naloxegol exposure; the combination is contraindicated. B confuses strong inhibition with the reduced-dose strategy used with moderate inhibitors. C cannot prevent a metabolic interaction. D reverses the expected effect, which is increased exposure and toxicity. E makes an unsafe abrupt analgesic change while leaving the contraindicated pair unresolved.

Reference: Moventig naloxegol SmPC. https://www.medicines.org.uk/emc/product/6892/smpc