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Enoxaparin renal impairment — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentEnoxaparin renal impairmentGPhC CRA

A 74-year-old with eGFR 22 mL/min/1.73 m² takes colchicine 500 micrograms twice daily for an acute gout flare. He is now prescribed clarithromycin and reports new diarrhoea and proximal weakness. What is the safest action?

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Correct answer: D — Withhold colchicine and arrange urgent clinical review

Severe renal impairment and a strong CYP3A4/P-glycoprotein inhibitor substantially increase colchicine exposure. Diarrhoea and muscle weakness may herald serious toxicity. Colchicine should be withheld and urgent clinical review arranged; simple dose spacing does not prevent the interaction, and another macrolide should not be substituted without an authorised review.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment