Direct Meds UK

Asthma and Allergies

Asthma Hay Fever

Digestive Health

Acid Reflux IBS Threadworm

About You

Are you male and aged between 18-75?

Yes No

This question is required.

Do you smoke or drink?

Yes No

This question is required.

Have you taken Viagra (sildenafil), Levitra (vardenafil), Nipatra, Spedra or Cialis (tadalafil) at least 4 times previously without any side effects?

Yes No

This question is required.

Medication

Are you taking any medicines known as nitrates (often taken for chest pain/angina) or nitric oxide donors ('poppers')?

Often taken for chest pain/angina Can be administered as a spray, tablet or patch. Include glyceryl trinitrate, isosorbide mononitrate or isosorbide dinitrate

Yes No

This question is required.

Are you currently taking any medication from following (including over the counter, prescription or recreational drugs)?

Any treatment for erectile dysfunction apart from Viagra (sildenafil) , Levitra (vardenafil) or Cialis (tadalafil), Spedra (avanafil) Medicinal nitrates such as glycyryl trinitrate, isosorbide mononitrate or isosorbide dinitrate (including oral, transdermal and sublingual) Recreational drugs prohibited by law (Class A,B or C) Recreational nitrates such as amyl nitrate also known as "poppers" Alpha blockers (used to treat high blood pressure or urinary symptoms associated with benign prostatic hyperplasia, and including tamsulosin, doxazocin, prazocin terazocin & indoramin) Medicines to treat high blood pressure. Warfarin - used to to prevent heart attacks, strokes, and blood clots Anti-virals including (Atazanavir, etravirine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir) Nicorandil Anti-fungal medication such as Ketoconazole or itraconazole Quinidine/procainamide/amiodarone Theophylline Erythromycin/clarithromycin/cimetidine phenobarbital, phenytoin and carbamazepine (anticonvulsant medicines). Riociguat Rifampicin

Yes No

This question is required.

Agreement

Do you understand that erectile dysfunction can be associated with a number of contributing conditions eg hypertension, diabetes mellitus, high cholesterol or cardiovascular disease and you should consult your doctor within 6 months of starting treatment for a clinical review?

Yes No

This question is required.

In the rare event, I obtain a prolonged erection of more than 4 hours or experience any sudden visual impairment, I agree that I will seek immediate medical assistance.

Yes No

This question is required.

Do you agree to the following?

You will read the patient information leaflet supplied with your medication You will contact us and inform your GP of your medication if you experience any side effects of treatment, if you start new medication or if your medical conditions change during treatment. The treatment is solely for your own use You have answered all the above questions accurately and truthfully. You understand our prescribers take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health.

Yes No

This question is required.

Health

Do you have high blood pressure (above 160/90), or are you currently on treatment for high blood pressure?

If you do not know your blood pressure you can have this measured at your local pharmacy/GP surgery.

Yes No

This question is required.

Do you have low blood pressure (below 90/50)?

If you do not know your blood pressure you can have this measured at your local pharmacy/GP surgery.

Yes No

This question is required.

Have you been advised to avoid strenuous exercise?

Yes No

This question is required.

Would you have any difficulty walking at a fast pace for 5 minutes?

Yes No

This question is required.

Do you suffer from depression for which you have not seen a GP?

Yes No

This question is required.

Do you have any allergy to Viagra (sildenafil), Levitra (vardenafil), Spedra (avanafil) or Cialis (tadalafil) or have you experienced any adverse reaction to any erectile dysfunction medication previously?

Yes No

This question is required.

ave you ever suffered from any of the problems listed below?

Any heart problems including angina, chest pain, heart failure, irregular heart beats, heart attack (myocardial infarction), left-ventricular outflow obstruction, cardiomyopathy or valvular heart disease (e.g.aortic stenosis). Stroke Sight loss due to poor circulation Sight loss because of non-arteritic anterior ischemic optic neuropathy (NAION) Blood problems such as haemophilia, sickle cell anaemia (an abnormality of red blood cells), leukaemia (cancer of blood cells) Stomach ulcers (e.g. peptic/gastric ulcer) Liver problems Kidney problems An erection that lasted more than 4 hours Any physical condition affecting the shape of the penis (e.g. angulation, Peyronie’s disease and cavernosal fibrosis) Inherited eye disease - retinitis pigmentosa Multiple myeloma (cancer of the bone marrow) Galactose intolerance, Lapp Lactase deficiency or glucose-galactose malabsorption Any serious medical condition which may require immediate hospitalisation

Yes No

This question is required.

Symptoms

Do you have trouble achieving or maintaining your erection?

Yes No

This question is required.

In the past 6 months, how often do you have difficulty getting and/or sustaining an erection during sexual activity?

Always Often Occasionally

This question is required.

Are you male and aged between 18-75?

Do you smoke or drink?

Have you taken Viagra (sildenafil), Levitra (vardenafil), Nipatra, Spedra or Cialis (tadalafil) at least 4 times previously without any side effects?

Are you taking any medicines known as nitrates (often taken for chest pain/angina) or nitric oxide donors ('poppers')?

Are you currently taking any medication from following (including over the counter, prescription or recreational drugs)?

Do you understand that erectile dysfunction can be associated with a number of contributing conditions eg hypertension, diabetes mellitus, high cholesterol or cardiovascular disease and you should consult your doctor within 6 months of starting treatment for a clinical review?

In the rare event, I obtain a prolonged erection of more than 4 hours or experience any sudden visual impairment, I agree that I will seek immediate medical assistance.

Do you agree to the following?

Do you have high blood pressure (above 160/90), or are you currently on treatment for high blood pressure?

Do you have low blood pressure (below 90/50)?

Have you been advised to avoid strenuous exercise?

Would you have any difficulty walking at a fast pace for 5 minutes?

Do you suffer from depression for which you have not seen a GP?

Do you have any allergy to Viagra (sildenafil), Levitra (vardenafil), Spedra (avanafil) or Cialis (tadalafil) or have you experienced any adverse reaction to any erectile dysfunction medication previously?

ave you ever suffered from any of the problems listed below?

Do you have trouble achieving or maintaining your erection?

In the past 6 months, how often do you have difficulty getting and/or sustaining an erection during sexual activity?

Confidential & Secure

Need help?

Treatments

Service

Weight Loss

Sexual Performance

Sexual Health

STIs

Pain Relief

Hair, Skin and Nails

Asthma and Allergies

Digestive Health

Erectile Dysfunction - Consultation

Answer quick questions to check your eligibility

Are you male and aged between 18-75?

Do you smoke or drink?

Have you taken Viagra (sildenafil), Levitra (vardenafil), Nipatra, Spedra or Cialis (tadalafil) at least 4 times previously without any side effects?

Are you taking any medicines known as nitrates (often taken for chest pain/angina) or nitric oxide donors ('poppers')?

Are you currently taking any medication from following (including over the counter, prescription or recreational drugs)?

Do you understand that erectile dysfunction can be associated with a number of contributing conditions eg hypertension, diabetes mellitus, high cholesterol or cardiovascular disease and you should consult your doctor within 6 months of starting treatment for a clinical review?

In the rare event, I obtain a prolonged erection of more than 4 hours or experience any sudden visual impairment, I agree that I will seek immediate medical assistance.

Do you agree to the following?

Do you have high blood pressure (above 160/90), or are you currently on treatment for high blood pressure?

Do you have low blood pressure (below 90/50)?

Have you been advised to avoid strenuous exercise?

Would you have any difficulty walking at a fast pace for 5 minutes?

Do you suffer from depression for which you have not seen a GP?

Do you have any allergy to Viagra (sildenafil), Levitra (vardenafil), Spedra (avanafil) or Cialis (tadalafil) or have you experienced any adverse reaction to any erectile dysfunction medication previously?

ave you ever suffered from any of the problems listed below?

Do you have trouble achieving or maintaining your erection?

In the past 6 months, how often do you have difficulty getting and/or sustaining an erection during sexual activity?

Confidential & Secure

Need help?

Treatments

Service