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Opioid choice in renal failure — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentOpioid choice in renal failureGPhC CRA

A patient with stage 5 chronic kidney disease is prescribed codeine for chronic pain. He reports confusion and constipation after a few doses. What is the most appropriate action?

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Correct answer: A — Refer to the prescriber to review analgesia in renal impairment

Codeine and its metabolites can accumulate in renal impairment and cause CNS adverse effects. Analgesic choice and dose should be reviewed in severe kidney disease, often with specialist input. The other options either delay appropriate care, use an unsuitable medicine, or miss the main safety issue.

Reference: BNF; NICE CKS