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Nitrofurantoin low eGFR — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentNitrofurantoin low eGFRGPhC CRA

A patient with recurrent UTI has nitrofurantoin issued, but the PMR notes eGFR 29 mL/min/1.73 m2 last month. What is the most appropriate alternative?

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

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Correct answer: E — Choose an alternative not mainly dependent on renal urinary excretion

Reduced renal function may reduce nitrofurantoin urinary efficacy and increase adverse effects. The prescriber should consider an appropriate alternative. In this scenario, the correct option is choose an alternative not mainly dependent on renal urinary excretion. The other options are plausible but do not address the key clinical, legal or safety issue as directly. This aligns with UK pharmacy practice guidance cited in the reference field.

Reference: BNF; NICE CKS