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Metformin eGFR decline — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentMetformin eGFR declineGPhC CRA

A 73-year-old man taking metformin 1 g twice daily has a new eGFR of 26 mL/min/1.73 m². He is otherwise stable and asks for his repeat prescription. What is the most appropriate action?

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Correct answer: C — Query continuation because metformin is generally avoided at this level of renal impairment

Metformin accumulation in significant renal impairment increases lactic acidosis risk. eGFR 26 requires prescriber review and likely discontinuation or alternative therapy. The pharmacist should not make an unsupervised diabetes medicine switch.

Reference: BNF; NICE CKS