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Anticoagulant in severe renal impairment — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentAnticoagulant in severe renal impairmentGPhC CRA

A patient with advanced CKD is prescribed dabigatran for atrial fibrillation. The prescriber asks the pharmacist to screen the prescription. What is the most appropriate alternative?

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

Reveal the answer and explanation

Correct answer: D — Discuss an alternative anticoagulation plan with specialist input

Dabigatran is highly renally cleared and may be unsuitable in severe renal impairment. The best answer addresses the key safety, legal or pharmaceutical care issue in the vignette. The other options would either delay appropriate care, create a new risk, or fail to resolve the issue. This is consistent with the cited UK reference for safe pharmacy practice.

Reference: BNF