Which of the following is an absolute contraindication to prescribing a GLP-1 receptor agonist such as liraglutide for type 2 diabetes?
- A History of pancreatitis five years ago
- B Personal history of medullary thyroid carcinoma ✓
- C Stage 3 chronic kidney disease with eGFR 45 mL/min/1.73 m²
- D Concurrent use of a dipeptidyl peptidase-4 inhibitor
Correct answer: B. Personal history of medullary thyroid carcinoma
Explanation
GLP-1 receptor agonists caused C-cell thyroid tumours in rodents through GLP-1 receptors on thyroid C cells, so they carry a boxed warning and are contraindicated in patients with personal or family history of medullary thyroid carcinoma or MEN2. Prior pancreatitis warrants caution but is not an absolute contraindication. These agents are renally protective and safe in stage 3 CKD.
Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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