Which antidepressant should be avoided in CrCl < 30 mL/min due to increased GI adverse events?

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Multiple Choice

Which antidepressant should be avoided in CrCl < 30 mL/min due to increased GI adverse events?

Explanation:
Duloxetine is the one to avoid when creatinine clearance is under 30 mL/min due to a higher risk of gastrointestinal adverse events. Duloxetine is cleared in part by the kidneys, so severe renal impairment leads to greater drug exposure. That increased exposure commonly manifests as nausea, vomiting, and other GI side effects, making it a poorer choice in CrCl < 30 mL/min. The other antidepressants listed (sertraline, citalopram, fluoxetine) do not have the same level of increased GI risk tied to severe renal impairment, so they are less problematic in this specific scenario.

Duloxetine is the one to avoid when creatinine clearance is under 30 mL/min due to a higher risk of gastrointestinal adverse events. Duloxetine is cleared in part by the kidneys, so severe renal impairment leads to greater drug exposure. That increased exposure commonly manifests as nausea, vomiting, and other GI side effects, making it a poorer choice in CrCl < 30 mL/min. The other antidepressants listed (sertraline, citalopram, fluoxetine) do not have the same level of increased GI risk tied to severe renal impairment, so they are less problematic in this specific scenario.

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