Treatment Questions | Pharma Aesthetics

Answer medical questions to order

Have you read the rosacea medical information?

Yes No

Are you aware you should see a doctor for a diagnosis of rosacea BEFORE using rosacea treatments? Have you seen your Dr and been diagnosed with Rosacea?

Yes No

Are you pregnant or breastfeeding?

Yes No

Are you aware gels and creams for rosacea should not be applied close to the eyes or lips or to open sores?

Yes No

Are you taking warfarin or other coumarin type blood thinning tablets, or do you have any type of blood disorder?

Yes No

There is an interaction with Rozex and Efracea.

Are you aware Mirvaso can cause worsening of symptoms in up to 16% of people?

Yes No

Worsening of redness can occur soon after Mirvaso is applied or later when the effects are wearing off (after 8-12 hrs). Stop using if it worsens symptoms. Most people recover on stopping treatment. Mirvaso should be built-up gradually to avoid worsening rosacea. Mirvaso usually improves symptoms in 70% of people - it does not work for everyone.

Have you been diagnosed with a medical condition causing significant low blood pressure?

Yes No

This applies mainly to severe uncontrolled heart disease.

Have you been diagnosed with any of the following:

Yes No

Depression, or are taking an antidepressant. Liver or kidney disease - not including simple water infections. Sjorgen's syndrome (uncommon immune condition causing dry skin). Poor circulation to the hands or feet.

Are you aware Mirvaso should be stopped and a doctor consulted if symptoms are worsening or you experience side effects?

Yes No

Are you aware Soolantra cream may worsen symptoms in the first week but this should settle?

Yes No

Are you taking Levamisole?

Yes No

Levamisole is rarely used to treat roundworm infection. There is an interaction with Soolantra.

Are you allergic to doxycycline or tetracycline antibiotics?

Yes No

Do you have rosacea affecting the eyes?

Yes No

Have you been diagnosed with colitis or myasthenia gravis?

Yes No

Do you have reduced stomach acidity, or oesophageal (gullet) irritation/ulceration, or are you taking medication to reduce stomach acid?

Yes No

E.g. antacid medication, Gaviscon, omeprazole, lansoprazole, esomeprazole, pantoprazole.

Are you aware that you should not use sunbeds or expose skin to strong sunlight whilst taking Efracea capsules?

Yes No

There is an increased risk of skin reactions if taking Efracea whilst using sunbeds or exposing the skin to strong sunlight. Strong sunlight and sunbeds can also worsen rosacea.

Are you taking any of the following?

Yes No

These medications interact with Efracea: Rifampicin (tuberculosis) Barbiturates (sedatives) Carbamazepine, phenytoin, primidone (epilepsy) Lithium (mood stabiliser) Retinoids e.g. isotretinoin, alitretinoin, acitretin (acne, psoriasis or severe rosacea) Cyclosporin (organ transplant) Penicillin type antibiotics e.g. amoxicillin Sulphonylurea drugs (diabetes) e.g. gliclazide

Do you have any further medical information or questions?

Yes No

Is there anything you do not understand or do you need further help?

Do all the following apply to you?

Yes No

The medication is for my own use and I will not share with anyone else I will read the information leaflet supplied with the medication I am over 18 and I agree to identity verification checks I have completed this questionnaire myself and fully understand all the information My responses are honest and accurate, and I understand that this is necessary for a safe medical assessment I agree to the terms & conditions, privacy policy, data sharing policy & consent to cookies

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