Treatment Questions | Pharma Aesthetics

Answer medical questions to order

Have you read the medical information?

Yes No

Pharma Aesthetics prescribes azithromycin only for travellers' diarrhoea - not to treat other conditions including chlamydia and mycoplasma.

Are you aware self-treatment with antibiotics is ONLY suitable for the following people?

Yes No

If going to a remote location with little or no access to good medical assistance. If you are at high risk of the diarrhoea leading to severe illness e.g. poorly controlled diabetes, renal impairment, heart failure, reduced CD4 HIV or other reduced immunity. With pre-existing bowel problems where infection may trigger a relapse e.g. ulcerative colitis, Crohn's disease, coeliac disease, and previous bowel surgery. With a tendency to severe travellers' diarrhoea (on the basis of previous travel experience)

Are you travelling to Europe, North America, or Australasia?

Yes No

Are you allergic to azithromycin, erythromycin, or clarithromycin?

Yes No

Have you been diagnosed with liver, kidney, or heart disease - including a tendency to irregular heartbeat, or myasthenia gravis?

Yes No

Are you taking any of the following medications regularly?

Yes No

These medications interact with azithromycin: Ciclosporin - for reducing immunity after transplant Digoxin - for irregular heart or heart failure Ergotamine - taken rarely for migraine Terfenadine - antihistamine for hay fever and allergy Theophylline - for asthma, used rarely Disopyramide, Amiodarone, Sotalol or other medication for irregular heart Rifabutin - anti-tuberculosis antibiotic, used rarely Coumarins - anticoagulant for thinning the blood -includes warfarin Promethazine (including Avomine) - NOT to be taken at the same time as azithromycin Colchicine - for gout and familial Mediterranean fever Antacids - for indigestion Warfarin, edoxaban, ticagrelor, or any similar medicines - to prevent blood clots Talazoparib, topotecan - specialist cancer drugs Antidepressant or antipsychotic medication Quinolone antibiotics, e.g. moxifloxacin, levofloxacin, ciprofloxacin Hydroxychloroquine or chloroquine - used for autoimmune diseases such as rheumatoid arthritis or to treat malaria There is a very rare theoretical risk of abnormal heart rhythm if azithromycin is taken at the same time as some other medications - please check this list.

Are you planning to take azithromycin whilst pregnant, trying to get pregnant, or breastfeeding?

Yes No

Are you aware traveller's diarrhoea should start to improve within 24 hours of starting antibiotic?

Yes No

Do you agree to azithromycin being supplied to you for travellers' diarrhoea 'off label'?

Yes No

If a medicine is used for an off label (unlicensed) purpose the manufacturer is not liable in case of adverse events. Doctors take the responsibility for the prescribing.

Are you allergic to loperamide?

Yes No

Have you been diagnosed with ulcerative colitis?

Yes No

Are you prone to constipation or bowel obstruction?

Yes No

Loperamide can cause constipation.

Are you taking any of the following medication?

Yes No

Ritonavir (for HIV) Quinidine (for abnormal heart rhythms or malaria) Itraconazole or ketoconazole (for fungal infections) Gemfibrozil (for high cholesterol)

Are you aware loperamide can cause drowsiness or dizziness?

Yes No

Caution if driving, cycling, or operating machinery.

Are you aware that loperamide should not be used when diarrhoea contains blood or there is prolonged (more than 24 hours) high fever?

Yes No

Seek medical advice if diarrhoea contains blood or there is prolonged fever.

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 my tablets 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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Travellers' diarrhoea

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