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Metformin dehydration — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentMetformin dehydrationGPhC CRA

A patient taking metformin and ramipril has diarrhoea and vomiting from gastroenteritis. They are passing little urine and ask whether to continue regular medicines. What monitoring is required?

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Correct answer: D — Seek clinical advice and follow sick-day guidance for metformin and renal-risk medicines

Vomiting, diarrhoea and reduced urine output increase the risk of dehydration and acute kidney injury. Metformin and medicines affecting renal perfusion may need temporary withholding under sick-day guidance with clinical advice. NSAIDs can worsen AKI risk. Permanent cessation of medicines is not appropriate without review.

Reference: BNF; NICE CKS