Sexual Health

Are you pregnant, breast feeding or intending to become pregnant?

Has your GP or specialist consultant diagnosed the condition for which you intend to take this medication and is happy for you take it?

Are there any other symptoms or underlying medical conditions the prescribing doctor needs to be aware of?

Do you have any allergies, side effects or adverse reactions with any medications in the past?

Do you have any history of blood electrolyte problems or liver problems?

Do you have any serious medical conditions which may necessitate immediate hospital review?

Do you take any of the following medications? Aliskiren, Aminophylline, Beta-blockers, Ceritinib, Chemotherapy, Colchicine, Dabigatran, Digoxin, Edoxaban, Lomitapide, Nintedanib, Rifabutin and Ticagrelor).

Have you recently tested positive for Chlamydia?

Are you taking any of the following medications? 

• Antacids - used for heartburn and indigestion
• Ergotamine - used for migraines
• Cholesterol lowering medicines (statins)
• Warfarin or similar medicines - used to thin the blood. Azithromycin can thin the blood even more
• Cisapride - used to treat stomach problems. Should not be taken at the same time as this may cause severe heart problems
• Terfenadine - used to treat hay fever. Should not be taken at the same time as this may cause severe heart problems
• Zidovudine or nelfinavir - used to treat HIV infection
• Rifabutin - used to treat tuberculosis (TB)
• Quinidine - used to treat heart rhythm problems
• Cyclosporin - used to stop your body rejecting an organ transplant
• Alfentanil - a painkiller used e.g. during operations
• Theophylline - used for breathing problems
• Digoxin - used to treat heart problems
• Astemizole - used to treat hay fever
• Pimozide - used to treat mental health problems
• Disopyramide
• Droperidol
• Mizolastine
• Reboxetine

Are you taking any other medication?

Do you understand sexual abstinence is advised for 7 days after treatment?

Do you suffer from kidney problems?

Are you experiencing any of the following?

• Unintentional weight loss
• Chest pain
• Blood in urine
• Pain when urinating
• Blood in your stools
• Urinary tract infections (UTI)
• Night sweats Fever

I agree to the following:

• I will read the patient information leaflet supplied with my medication
• I will contact my GP or MyMedsUK if I experience any side effects
• The treatment is for my use only
• I have answered the assessment questions truthfully and accurately
• I agree to the Terms and Conditions and I confirm that I am over 18 years old
• I am aware that I may be contacted to give further information via phone or email and if I am not contactable this will lead to a delay in receipt of my prescription