About you

Are you aged between 18 and 60?

We are unable to supply you the product. Please consult your GP.

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Are you pregnant or breast feeding, or intending either whilst on this medication?

We are unable to supply you the product. Please consult your GP.

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Other Medical Conditions

Do you have any of the following:

  • liver or kidney disease
  • heart problems, including heart rhythm problems
  • any other chronic disease (such as diabetes)
  • galactose intolerance, Lapp Lactase deficiency or glucose-galactose malabsorption
  • a weakened immune system

We are unable to supply you the product. Please consult your GP.

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Are you experiencing any of the following:

 

For women only:

  • abnormal or irregular vaginal bleeding or a blood-stained discharge
  • vulval or vaginal ulcers, blisters or sores
  • lower abdominal pain or pain when urinating
  • fever or chills
  • nausea or vomiting
  • diarrhoea
  • foul smelling vaginal discharge

For men only:

  • penile sores, ulcers or blisters
  • abnormal penile discharge
  • penis has started to smell
  • pain on passing urine

We are unable to supply you the product. Please consult your GP.

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Other Medication

You are not taking any of the following:

  • terfenadine and astemizole
  • cisapride
  • pimozide
  • quinidine
  • erythromycin
  • any medicine (other than contraceptive pill)

We are unable to supply you the product. Please consult your GP.

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Agreement:

You confirm that you:

  • If intended user is male, their sexual partner has thrush
  • Have not had more than two infections of thrush in the last 6 months
  • Are not allergic (hypersensitive) to fluconazole, other antifungals and thrush treatments or any other ingredient
  • Do not have a history of a sexually transmitted disease or exposure to a partner with sexually transmitted disease
  • Understand that the dose for one treatment is a single 150mg tablet of fluconazole and that not more than one capsule should be taken within a 7 day period of time

Please confirm that you understand.

Please complete this question.

Do you agree with the below:

  • The treatment is for your own use
  • You will contact us and your GP should you experience any side effects from the treatment, if your condition changes or if your medical circumstances change.
  • You will read the patient information leaflet supplied with your medication
  • You have completed this questionnaire yourself and fully understand all the information
  • Your responses are honest and accurate, and you understand that this is necessary for a safe medical assessment
  • You agree to the terms & conditions, privacy policy, & data sharing policy

Please confirm that you understand.

Please complete this question.

COMPLETE OUR 2 MINUTE QUESTIONNAIRE

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To find a treatment suitable for you, we just need you to answer a few questions.

Confidential & Secure

  • We will review your details in complete confidence
  • Your medication will be delivered in plain unlabelled packaging
  • Appears on your statement as "Pharma"
  • All data is securely encrypted with 256-bit SSL