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Metformin renal impairment — GPhC CRA MCQ

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HardEndocrine TherapeuticsMetformin renal impairmentGPhC CRA

A patient with an ileostomy sees intact modified-release tablets in the stoma bag and reports loss of symptom control. What should the pharmacist consider first?

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Correct answer: D — Reduced release or absorption from shortened transit

A shortened gastrointestinal transit can reduce release and absorption of modified-release or enteric-coated formulations, although some inert shells may appear after drug release. Review the specific product, symptoms and stoma output with the prescriber and consider a suitable immediate-release or alternative formulation; never crush modified-release tablets indiscriminately.

Reference: https://www.sps.nhs.uk/articles/choosing-formulations-of-medicines-for-adults-with-swallowing-difficulties/