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ACE inhibitor renal monitoring — GPhC CRA MCQ

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HardCardiovascular TherapeuticsACE inhibitor renal monitoringGPhC CRA

A 56-year-old woman with hypertension takes ramipril 5 mg daily. Her dose was increased to 10 mg a week ago; blood tests now show creatinine has risen from 82 to 118 micromol/L and potassium is 5.7 mmol/L. What is the most appropriate action?

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

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Correct answer: C — Withhold supply pending urgent prescriber review of renal function and potassium

ACE inhibitors can cause a rise in creatinine and potassium after initiation or dose increase. A significant creatinine rise with potassium 5.7 mmol/L requires prompt clinical review before continuing the higher dose. Dietary advice alone is insufficient and spironolactone would worsen hyperkalaemia risk.

Reference: BNF; NICE CKS