01493668097
Your Chemists

Office Address

Gorleston Pharmacy, 8 Lowestoft Road, Gorleston, NR31 6LY

Phone Number

01493668097

Email Address

mansour.dadkhah@nhs.net

Information

Company Registration: 7448961 Premises GPhC Number: 1035247 Superintendent: Mansour Dadkhah (2060377)

Herpes

Genital herpes is a very common, highly contagious infection usually spread through unprotected sex. It’s typically caused by the herpes simplex virus-2 (HSV-2), and sometimes the herpes simplex virus-1 (HSV-1) — that’s the virus often responsible for cold sores. Symptoms of herpes include blisters similar to cold sores on the genitals, although in many people who have it, it produces mild or no symptoms.

  • About You
  • Symptoms
  • Health
  • Medication
  • Agreement
Our doctors would now like to check your suitability for this product

Are you aged between 18 and 65?

Have you been diagnosed by your GP or GUM clinic with Genital Herpes (HSV-1 or HSV-2)?

Are you experiencing any of the following?

  • thrush
  • unintentional weight loss
  • chest pain
  • blood in your urine
  • pain when urinating
  • blood in your stools
  • urinary tract infections (UTI)
  • night sweats
  • fever

Do you have an allergy (hypersensitivity) to medicines containing Aciclovir or Valciclovir or Famaciclovir or Penciclovir?

Are you breast feeding or pregnant or possibly pregnant?

Have you been diagnosed with any of the following?

  • Liver problems
  • Kidney problems
  • Immunodeficiency conditions (eg. HIV)
  • Nervous system abnormalities
  • Any serious medical condition which may require immediate hospitalisation

Are you currently taking any medication (including over the counter, prescription or recreational drugs)?

Are you taking any of the following medications?

  • cimetidine (used to treat peptic ulcers)
  • probenecid (used to treat gout)
  • raloxifen
  • medicines that suppress your immune system (e.g. mycophenolate mofetil; ciclosporin; tacrolimus; methotrexate)
  • theophylline and aminophylline (used in asthma and other breathing problems)
  • zidovudine (used in HIV infection)
  • any medicine which affects the kidneys, including aminoglycosides, organoplatinum compounds, iodinated contrast media, pentamidine, foscarnet

Do you understand that you should maintain genital hygiene and avoid sexual contact during your outbreak?

Do you understand that you should drink water regularly during your treatment? This will help reduce side effects that can effect your kidneys or nervous system.

Do you understand that if your symptoms do not improve after 7 days you must see your doctor?

Do you agree to the following?

  • You will read the patient information leaflet supplied with your medication
  • You will contact us and inform your GP of your medication if you experience any side effects of treatment, if you start new medication or if - your medical conditions change during treatment.
  • The treatment is solely for your own use
  • You have answered all the above questions accurately and truthfully. You understand our prescribers take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health.

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