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Morphine in renal impairment — GPhC CRA MCQ

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ModerateCNS TherapeuticsMorphine in renal impairmentGPhC CRA

A 78-year-old woman with chronic kidney disease stage 4 is prescribed morphine oral solution for persistent pain after a fall. Her eGFR is 22mL/min/1.73m2 and she is opioid-naïve. What is the most appropriate alternative?

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Correct answer: B — Query the prescription because morphine metabolites can accumulate in renal impairment

Morphine active metabolites can accumulate in significant renal impairment, increasing sedation and respiratory depression risk. Opioid choice and dose should be reviewed carefully in CKD. The pharmacist should contact the prescriber before supply, especially in an opioid-naïve older patient.

Reference: BNF