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Metformin sick day — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsMetformin sick dayGPhC CRA

A patient taking metformin and ramipril has vomiting and poor oral intake from gastroenteritis. What is the most appropriate action?

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

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Correct answer: B — Advise temporary withholding and urgent review if dehydration persists

Metformin should be withheld during significant acute illness with dehydration risk because lactic acidosis risk increases. In this vignette, "Advise temporary withholding and urgent review if dehydration persists" is the safest single best answer. The other options are less appropriate because they miss the key clinical risk, conflict with UK medicines guidance, or delay needed review.

Reference: BNF; NICE CKS