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Metformin renal dose safety — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentMetformin renal dose safetyGPhC CRA

A patient takes metformin 1 g twice daily and has stable eGFR 38 mL/min/1.73 m². Which medicine-safety action is required?

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

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Correct answer: A — Review the dose and monitor renal function at shorter intervals

When eGFR falls below 45, metformin dose and ongoing suitability need review and renal function should be monitored more frequently. It is generally stopped below eGFR 30 or during acute dehydrating illness; formulation change alone does not remove accumulation risk.

Reference: BNF: metformin hydrochloride: https://bnf.nice.org.uk/drugs/metformin-hydrochloride/