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HardPharmacologyAnalgesia in CKDmrcgp aktukmlapanemrcp part 1prescribing safety assessment

A 60-year-old man with chronic kidney disease stage 4 (eGFR 25 ml/min/1.73m$^2$) requires analgesia for moderate osteoarthritis pain unresponsive to paracetamol. Which opioid analgesic should generally be avoided or used with extreme caution in this patient according to the BNF?

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