skip to main content

Metformin and acute kidney injury risk — GPhC CRA MCQ

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

HardEndocrine TherapeuticsMetformin and acute kidney injury riskGPhC CRA

A 71-year-old taking metformin 1 g twice daily has gastroenteritis, poor intake and oliguria. eGFR was 38 mL/min/1.73 m² before this illness. What is the best immediate advice?

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

Reveal the answer and explanation

Correct answer: C — Withhold metformin and obtain urgent assessment for possible acute kidney injury

Oliguria during vomiting and poor intake suggests acute kidney injury. Metformin should be temporarily stopped in acute conditions that can alter renal function because accumulation increases lactic-acidosis risk. The patient also requires urgent assessment of hydration, renal function and other medicines; this is not the contrast-media 48-hour rule, and the pharmacist should not initiate a sulfonylurea independently.

Reference: Metformin SmPC: https://www.medicines.org.uk/emc/product/13160/smpc