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ACE inhibitor monitoring — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsACE inhibitor monitoringGPhC CRA

A GP starts ramipril 2.5 mg once daily for a 67-year-old man with hypertension and chronic kidney disease stage 3a. Baseline potassium is 4.7 mmol/L and eGFR is 54 mL/min/1.73 m2. He asks when blood tests should be repeated. What monitoring is required?

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Correct answer: B — Urea, electrolytes and creatinine in 1 to 2 weeks

ACE inhibitors can increase potassium and reduce renal function, particularly in patients with chronic kidney disease. Urea, electrolytes and creatinine should be checked after initiation and after dose changes, commonly within 1 to 2 weeks. The result determines whether dose titration can continue safely.

Reference: BNF; NICE CKS