Consultation - Mentor Pharmacy

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Group 1

Group 2

Group 3

1 Group 1

Enter your name

How old are you

<25

25-34

>35

no match

How often do you have trouble getting an erection?

Always

Frequently

Sometimes

Rarely

no match

2 Group 2

Have you been told to refrain from strenuous physical activity?

Yes

Do you experience shortness of breath or chest pain during light activity, such as a 20 minute walk or climbing two flights of stairs?

Yes

Do you have any allergies or medication reactions? Include any allergies to food, lactose, dyes, prescription or over the counter medicines, such as antibiotics, allergy medications, herbs, vitamins, supplements or anything else

Free text

Are you taking any medication, including anything bought over the counter? Ensure you select yes if you take prescription medication for any chronic medical condition such as, diabetes, high cholesterol or high blood pressure

free text

Just to confirm, are you taking any of the following medication?c

Alpha-blocker medication such as alfuzosin, doxazosin, tamsulosin, prazosin, terazosin, indoramin or over-the-counter Flomax (used for high blood pressure or urinary symptoms related to benign prostatic hyperplasia)

Medicinal nitrates, such as glyceryl trinitrate, isosorbide mononitrate, or isosorbide dinitrate (including oral, transdermal, and sublingual forms)

Diltiazem (for high blood pressure)

Warfarin (used to prevent blood clots, strokes and heart attacks)

Quinidine, procainamide, amiodarone (used for irregular heartbeats)

Phenobarbital, phenytoin and carbamazepine (anticonvulsant medicines)

Theophylline, riociguat or other guanylate cyclase stimulators (for lung conditions)

Erythromycin, rifampicin or clarithromycin (antibiotics)

Saquinavir, ritonavir, indinavir, atazanavir, etravirine, fosamprenavir,

nelfinavir (for HIV)

Ketoconazole or itraconazole (fungal infections)

Cimetidine (for reflux or heartburn)

Nicorandril (for chest pains)

3 Group 3

Do you currently have, or are you receiving treatment for, any medical conditions or surgeries?

free text

Have you ever had any of the following?

Health issues relating to your heart including angina, chest pain, heart failure, irregular heartbeats, heart attack (myocardial infarction), left-ventricular outflow obstruction, cardiomyopathy, valvular heart disease or aortic stenosis.

Stroke or blood clotting disorders

Liver conditions (such as cirrhosis) or kidney problems

Advised to avoid sexual activity for any medical reason

Abnormal blood pressure (lower than 90/50 mmHg or higher than 160/90 mmHg)

Condition affecting your penis such as Peyronies disease, priapism (an erection that lasted more than 4 hours) or previous injuries

History of loss of vision because of damage to the optic nerve (non-arterific ischaemic optic neuropathy) or a hereditary retinal problem such as retinitis pigmentosa or due to poor circulation

Galactose intolerance, Glucose-galactose malabsorption or Lapp lactase deficiency

Any conditions relating to the blood such as haemophilia, sickle cell anaemia or leukaemia

Stomach/ duodenal ulcers

Multiple myeloma (bone marrow cancer)

Mental health challenges that may affect capacity

Have you taken any of the following recreational drugs within 6 months; poppers, amyl, butyl nitrates, methamphetamine, meth, cocaine, MDMA or ecstasy?

Yes

Have you tried traditionally available medication for erectile dysfunction medications?

Yes

Which of the following treatments have you used in the past?

Tadalafil (Cialis or generic)

Sildenafil (Viagra or generic)

Vardenafil (Levitra or generic)

Avanafil (Stendra)

Other (free text)

no match

Was this effective for you?

Yes

no match

Assessment Progress

1 Group 1
2 Group 2
3 Group 3

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GPhC-registered pharmacy

UK prescribers review every order

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Next-day delivery available

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Acne

Asthma

Contraceptives

Eczema and Dermatitis

Erectile Dysfunction

Hay Fever

Menopause

Shingles

Urinary Tract Infection (UTI)

Ear Wax Removal

Private Blood Tests

1 Group 1

Enter your name

How old are you

How often do you have trouble getting an erection?

2 Group 2

Have you been told to refrain from strenuous physical activity?

Do you experience shortness of breath or chest pain during light activity, such as a 20 minute walk or climbing two flights of stairs?

Do you have any allergies or medication reactions? Include any allergies to food, lactose, dyes, prescription or over the counter medicines, such as antibiotics, allergy medications, herbs, vitamins, supplements or anything else

Free text

Are you taking any medication, including anything bought over the counter? Ensure you select yes if you take prescription medication for any chronic medical condition such as, diabetes, high cholesterol or high blood pressure

free text

Just to confirm, are you taking any of the following medication?c

3 Group 3

Do you currently have, or are you receiving treatment for, any medical conditions or surgeries?

free text

Have you ever had any of the following?

Have you taken any of the following recreational drugs within 6 months; poppers, amyl, butyl nitrates, methamphetamine, meth, cocaine, MDMA or ecstasy?

Have you tried traditionally available medication for erectile dysfunction medications?

Which of the following treatments have you used in the past?

Was this effective for you?

Assessment Progress

Quick Links

Acne

Asthma

Contraceptives

Eczema and Dermatitis

Erectile Dysfunction

Hay Fever

Menopause

Shingles

Urinary Tract Infection (UTI)

Ear Wax Removal

Private Blood Tests

Erectile Dysfunction

1 Group 1

Enter your name

How old are you

How often do you have trouble getting an erection?

2 Group 2

Have you been told to refrain from strenuous physical activity?

Do you experience shortness of breath or chest pain during light activity, such as a 20 minute walk or climbing two flights of stairs?

Do you have any allergies or medication reactions? Include any allergies to food, lactose, dyes, prescription or over the counter medicines, such as antibiotics, allergy medications, herbs, vitamins, supplements or anything else

Free text

Are you taking any medication, including anything bought over the counter? Ensure you select yes if you take prescription medication for any chronic medical condition such as, diabetes, high cholesterol or high blood pressure

free text

Just to confirm, are you taking any of the following medication?c

3 Group 3

Do you currently have, or are you receiving treatment for, any medical conditions or surgeries?

free text

Have you ever had any of the following?

Have you taken any of the following recreational drugs within 6 months; poppers, amyl, butyl nitrates, methamphetamine, meth, cocaine, MDMA or ecstasy?

Have you tried traditionally available medication for erectile dysfunction medications?

Which of the following treatments have you used in the past?

Was this effective for you?

Assessment Progress

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