skip to main content

ACE inhibitor monitoring — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardCardiovascular TherapeuticsACE inhibitor monitoringGPhC CRA

A GP asks about starting ramipril 2.5mg once daily for a 72-year-old woman with hypertension and CKD stage 3a. Her baseline creatinine is 116micromol/L, eGFR 48mL/min/1.73m2 and potassium 4.8mmol/L. She also takes indapamide 2.5mg each morning. What monitoring is required?

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

Reveal the answer and explanation

Correct answer: C — Urea, creatinine, eGFR and potassium in 1 to 2 weeks

ACE inhibitors can reduce renal perfusion and increase potassium, particularly in CKD and when combined with diuretics. Renal function and electrolytes should be checked shortly after initiation and after dose changes. The baseline potassium is within range but high enough to justify careful follow-up. Liver tests, calcium monitoring and HbA1c are not the key safety checks for starting ramipril.

Reference: NICE CKS Hypertension; BNF