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eGFR and metformin — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmenteGFR and metforminGPhC CRA

A discharge prescription includes metformin for a patient whose eGFR has fallen to 24 mL/min/1.73 m2. The patient is eating poorly after sepsis. What is the most appropriate action?

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Correct answer: E — Avoid and contact the prescriber before supply

Severe renal impairment and acute illness increase metformin-associated lactic acidosis risk. The prescription should be clarified before supply. In this scenario, the correct option is avoid and contact the prescriber before supply. 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