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Opioid renal impairment — GPhC CRA MCQ

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HardCNS TherapeuticsOpioid renal impairmentGPhC CRA

A 78-year-old man with stage 4 chronic kidney disease is prescribed morphine sulphate oral solution for persistent pain. His eGFR is 23 mL/min/1.73 m2 and he is opioid naive. What is the most appropriate alternative?

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Correct answer: A — Seek prescriber review for an opioid safer in renal impairment

Morphine metabolites can accumulate in significant renal impairment and increase toxicity risk. Opioid choice and starting dose should be reviewed carefully in advanced kidney disease. The pharmacist should contact the prescriber before supply rather than giving unsupervised dose modification advice.

Reference: BNF