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Muse 6 x 1000mcg Pellets

Muse 6 x 1000mcg Pellets

Muse 1000mcg [POM] - 6 Pellets

£75.00

Medicine Unit Quantity: 6

Medicine Unit Dosage Size: 1000mcg

Medicine Type: Pellet

Dosage Instructions: Use one pellet as directed in the information leaflet when requi

Prescription

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Prescription Form - £24.00
Erectile Dysfunction Prescription

Date of Birth

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Height Type

Meters - Feet

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Weight Type

Weight Amount

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How is your blood pressure?

If your blood pressure is not within normal limits please provide medications taken and/or readings

400 characters left

Do you smoke?

Do you drink alcohol?

Have you had any cardiovascular (heart) problems or have you ever had a stroke?

Can you walk 3 miles or climb a set of stairs without pain in your chest?

If no please provide details

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Do you suffer from any allergies?

Are you currently taking any medication whatsoever?

Have you recently finished any course of medication?

Is there a history of any disorder/s that has run within your family?

Have you ever had any surgery (operations)?

Can you think of any other health / medical details not mentioned above? If yes please indicate full history of medical problem and actions taken to remedy it?

It would be in your best interest if our doctor who prescribes for you can share information with your regular GP. If you would like your GP to be informed please state your consent below and enter your GP's name and practice address.

400 characters left

Would you like a free face to face consultation with our Doctor via Skype video?

I agree to read the patient leaflet before taking any medication (if prescribed).

Do you feel as though you suffer from impotence?

Do you have difficulty in achieving erections sufficient for penetration?

Do you generally have difficulty in maintaining an erection during sex?

How many years have you been suffering with this problem?

100 characters left

How many months have you been suffering with this problem?

100 characters left

Do you think there could be psychological causes for your problem eg anxiety or depression?

Do you have a condition where sexual intercourse is not advised (i.e. any severe heart disorders such as unstable angina or severe cardiac failure)?

Are you taking saquinavir / erythromycin / ketoconazole or itraconazole (please double check any medication bottles/packs that you may have).

Do you have a hereditary degenerative retinal disorder such as retinitis pigmentosa?

Are you taking any HIV medication like protease inhibitor eg ritonavir?

Are you taking nitric oxide donors (such as amyl nitrate) or nitrates in any form such as ‘poppers’?

Do you suffer from Peyronie's Disease

Do you have any abnormality of the penis?

Have you ever taken the medication you are requesting before?

Is there anything else which you feel we should know about prior to you taking this medication?

Please specify your gender

Do you declare that all of the answers on this website have been completed truthfully?

Qty

Muse 6 x 1000mcg Pellets

£75.00

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