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Metformin dose in CKD — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentMetformin dose in CKDGPhC CRA

A patient with eGFR 35 mL/min/1.73 m² and rising creatinine receives metformin 1 g three times daily. What is the pharmacist’s priority?

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Correct answer: D — Query the excessive renal-adjusted dose and arrange closer renal monitoring

Three grams daily is excessive in moderate renal impairment and declining function. Metformin dose and continued suitability need prompt prescriber review, with more frequent renal monitoring and sick-day counselling; formulation change or routine lactate testing does not make the dose safe.

Reference: BNF: metformin hydrochloride: https://bnf.nice.org.uk/drugs/metformin-hydrochloride/