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Metformin renal impairment — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsMetformin renal impairmentGPhC CRA

A patient taking metformin 1 g twice daily has an eGFR of 26 mL/min/1.73 m2 on a recent discharge summary. The repeat prescription is unchanged. What is the most appropriate action?

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

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Correct answer: E — Query continuation of metformin with the prescriber before supply

Metformin requires review in significant renal impairment because accumulation increases lactic acidosis risk. An eGFR of 26 mL/min/1.73 m2 should prompt prescriber review before continuation. The other options either delay appropriate care, use an unsuitable medicine, or miss the main safety issue.

Reference: BNF; NICE CKS