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Metformin renal function — GPhC CRA MCQ

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EasyEndocrine TherapeuticsMetformin renal functionGPhC CRA

A 67-year-old patient takes metformin 1g twice daily. Their latest eGFR has fallen to 28 mL/min/1.73 m2 after an acute illness. The GP asks for pharmacy advice before issuing the repeat. What monitoring is required?

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

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Correct answer: C — Withhold and review metformin due to renal impairment

Metformin is unsuitable at significantly reduced eGFR because of lactic acidosis risk. Acute illness and renal decline require prompt review before continuing treatment. Unsupervised switching or dose escalation would be unsafe.

Reference: BNF; NICE CKS