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Nitrofurantoin renal function — GPhC CRA MCQ

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HardInfectionsNitrofurantoin renal functionGPhC CRA

A 79-year-old woman presents a prescription for nitrofurantoin 100 mg modified-release twice daily for lower UTI. Her record shows eGFR 34 mL/min/1.73 m², temperature 37.1°C and no flank pain. What is the most appropriate alternative?

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Correct answer: E — Query suitability with the prescriber because eGFR is below usual use and supply depends on short-course risk assessment

Nitrofurantoin depends on renal secretion into urine and is generally avoided in significant renal impairment, although short courses may be used with caution in some patients at eGFR 30–44 mL/min/1.73 m². At eGFR 34, the pharmacist should check indication, duration and prescriber rationale. The absence of systemic features supports lower UTI, not admission. Modified-release capsules should not be crushed.

Reference: BNF; NICE CKS