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Erectile Dysfunction >> Sildenafil 50mg Tablet

Are you male and aged between 18-75?

Do you smoke or drink alcohol

Do you have difficulty achieving or maintaining an erection and are you using this medication to treat erectile dysfunction?

Do you have hypertension (High blood pressure above 160/90)
Do you have hypotension (Low blood pressure below 90/50)
Have you been advised to avoid strenuous exercise?
Have you ever had an allergic reaction or experienced severe side effects from taking erectile dysfunction medication?
Do you suffer from depression for which you have not seen a GP?
A Have you ever suffered from any of the problems listed below?
  • Heart disease (including stroke, mini stroke, recent heart attack, angina, cardiomyopathy or an irregular heartbeat)
  • Uncontrolled hypertension
  • Left ventricular outflow obstruction (for example aortic stenosis and idiopathic hypertrophic subaortic stenosis)
  • Non-anterior ischaemic optic neuropathy (NAION)
  • History of vision problems due to poor circulation or family history of eye degenerative eye disease e.g. retinitis peigmentosa
  • Kidney or liver problems
  • Priapism (erection that last longer than four hours) or anatomical deformation of the penis (including angulation, cavernosal fibrosis, or Peyronie's disease)
  • Blood disorders such as haemophilia, sickle cell disease (an abnormality of red blood cells), leukaemia (cancer of blood cells) or multiple myeloma (cancer of bone marrow)
  • Any condition where sexual activity is inadvisable such as unstable angina or heart failure
  • Stomach ulcers (peptic/gastric)
  • Galactose intolerance, LAPP lactase deficiency, or glucose-galactose malabsorption
  • Previous major pelvic surgery (including radical prostatectomy, radiotherapy (pelvis or retroperitoneum).
Are you currently taking any of the following medications such as nitrates for chest pain or angina.
  • Glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate.
  • As a spray, tablet or patch.
Are you currently taking any medication (including over the counter, prescription or recreational drugs)?
  • To read the patient information leaflet this will be given to you with your medication
  • To keep us and your GP informed when you start a new medication, if your medical condition changes during treatment or if you experience any side effects of treatment.
  • That the medication we supply you with will be only for your own personal use.
  • That you have answered the above questions truthfully and accurately. Our prescribers base their prescribing decisions on the answers you give and that any information you have provided that may be incorrect could have a detrimental effect on your health.
  • I declare that the information I have supplied is both complete and truthful and I agree to read the patient information leaflet provided before using this medication.*
  • I declare that I agree with the Customer Responsibility Statement*
  • I declare that I agree with the Informed Consent Agreement*
  • I declare that I agree with terms & Conditions and Privacy Policy