Which GLP-1 receptor agonist should be avoided or requires discontinuation once eGFR falls below 30 mL/min/1.73 m²?
- A Liraglutide
- B Exenatide ✓
- C Dulaglutide
- D Semaglutide
Correct answer: B. Exenatide
Explanation
Exenatide is cleared predominantly by the kidneys and is not recommended when eGFR is below 30 mL/min/1.73 m², with reports of nausea, vomiting and acute kidney injury linked to volume depletion in renal impairment. Liraglutide, semaglutide and dulaglutide are degraded proteolytically rather than renally cleared and need no dose adjustment across the range of renal function. This clearance difference is a frequently tested distinction within the incretin class.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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