NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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Which of the following drugs is contraindicated in CKD patients with a CrCl<60?

  1. Nitrofurantoin

  2. Metoprolol

  3. Captopril

  4. Furosemide

The correct answer is: Nitrofurantoin

Nitrofurantoin is contraindicated in CKD patients with a CrCl<60 because it is primarily renally excreted and can accumulate to toxic levels in patients with impaired renal function. Metoprolol and captopril are not primarily renally eliminated, so they can be used with caution and dose adjustment in patients with impaired renal function. Furosemide, on the other hand, is often used in CKD patients to manage fluid overload and hypertension despite impaired renal function, so it is not contraindicated in this population.

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