The questions to ask Cialis Together checklist for patient use
The questions to ask Cialis Together checklist for patient use
Going through the short checklist below will help you and your patient determine whether Cialis Together is suitable for them.
The Checklist can be downloaded below
Download
Patients can be given the Checklist to complete themselves, or alternatively you can use it in your consultation with the patient.
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Do you have, or have you ever had a heart problem (including any problems with your heart, blood pressure, feeling dizzy, blurred vision or a stroke)?
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Do you feel very breathless or get chest pain if you walk fast for 20 minutes or climb 2 flights of stairs?
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Have you ever been prescribed any nitrate medicine used to treat or prevent chest pain (angina), heart attack or heart failure?
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Are you using any recreational drugs (such as, but not limited to, ‘poppers’ [amyl nitrite] or cannabis)?
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Are you taking any other regular medication?
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Do you have any health conditions? For example:
a. Problems with your liver or kidneys
b. Blood diseases (e.g. leukaemia, sickle cell anaemia, multiple myeloma) -
Have you ever had loss of vision because of damage to your optic nerve (known as NAION) or do you have an inherited eye disease (e.g. retinitis pigmentosa)?
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Do you have Peyronie’s disease or any other condition causing a change in the shape of your penis?
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Do you have any allergies or intolerances (e.g. lactose intolerance)?
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Is there anything else you would like to tell the pharmacist about your health or medication?
Don’t forget to inform patients that erection problems can be a sign of another health condition such as heart disease, hypertension, diabetes or depression.
For repeat users…
You do not need to repeat these checks again with patients requesting a repeat supply of Cialis Together.
If a patient has previously been supplied with Cialis Together, confirm continued suitability for the product:
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Check that the patient has not experienced any problems related to Cialis Together. Check if they have experienced any side effects and provide advice on managing common side effects.
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Check that there are no changes in the patient’s health conditions or other medications since the last supply. Check for any changes that are contraindications or warnings (see steps 1-3 above), or if the patient has developed a new health condition that precludes supply.
Repeat Purchase Cards are available to help manage repeat supply. This is a card for patients to give to you or another pharmacist when they next request Cialis Together. The card has space to record the date of first supply, and a pharmacy stamp for verification.
A Referral Card is available to manage doctor referrals. Patients can take this card to their doctor if they need medical confirmation of suitability for Cialis Together.
All patients (first time and repeat supply patients) should see their doctor at the earliest opportunity and no later than 6 months after being supplied with Cialis Together to check they do not have any underlying conditions that could be causing their ED.