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Metformin renal impairment — GPhC CRA MCQ

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HardEndocrine TherapeuticsMetformin renal impairmentGPhC CRA

A 29-year-old taking valproate for epilepsy requests a repeat prescription. She could become pregnant, has no documented Pregnancy Prevention Programme review and says she may try to conceive. What is the safest pharmacy action?

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

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Correct answer: AArrange urgent specialist or prescriber review without abrupt withdrawal

Valproate carries substantial fetal risk and use in people who could become pregnant requires strict safeguards and specialist oversight. The pharmacist should urgently contact the prescriber or specialist and ensure pregnancy-prevention and preconception advice, but should not cause abrupt withdrawal because uncontrolled seizures can be dangerous. Antiseizure medicines cannot be exchanged using simple milligram equivalence.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment