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Home gonorrhoea treatment

Posted 12 June 2019 in Sexual Health

Home gonorrhoea treatmentThe World Health Organization, WHO, has estimated that one million new sexually transmitted infections (STIs) occur every single day. (1)

Overall, in the UK the cases of sexually transmitted infections are increasing.

In England alone, in 2018, there were 447,694 new diagnoses of STIs, a 5% increase on the 422,147 in 2017. (2)

Gonorrhoea increased the most, by 26% to 56,259 cases, the largest number since 1978.

The number of gonorrhoea cases has been increasing for years among both men and women, despite repeated warnings from public health doctors about the risks of unprotected sex.

Gonorrhoea, sometimes referred to as "The Clap", is a bacterial infection passed between people through unprotected sex.

About 50% of women and 10% of men are unaware that they’re infected as they don’t experience any obvious symptoms and this means that the infection can go untreated until the disease has progressed. This can lead to serious long-term health problems and infertility.

If symptoms are experienced, they usually occur about 10 days after being infected. Men and women are affected differently: (3)

Men may experience

  • Burning sensation/pain when urinating

  • Inflammation of the foreskin

  • An unusual discharge from the tip of the penis that may be green, yellow or white.

  • Tenderness or pain in the testicles

While women may experience

  • Burning sensation/pain when urinating

  • Bleeding between periods and/or heavier periods

  • A change in vaginal discharge which may be thick and green or yellow in colour.

  • Lower abdominal discomfort

  • Bleeding after sex

Testing

If you have put yourself at risk and are concerned, then you should wait 14 days before taking a test as it may take this amount of time before the infection can be detected.

If you visit your GP you will probably be signposted to a genitourinary medicine, GUM, clinic which may also be called a Sexual Health Clinic.  If you find it difficult to either get an appointment at a clinic or are simply short of time or indeed too embarrassed to go to a clinic, you can choose to order a test from us at Webmed Pharmacy.

Our test kits are sent to The Doctors Laboratory (TDL) in London. They are the largest independent providers of clinical laboratory diagnostic services in the UK. Once the lab has received your sample, your results will be available 2-3 days later.

The kits are posted in discreet plain unmarked packaging with no indication of their contents or who it‘s from.

Treatment

If your test is positive for gonorrhoea we can refer you to a GUM clinic for treatment. The first line treatment, as recommended by the British Association for Health and HIV, BASHH, is an injection of a single antibiotic.

If you can’t get to a GUM clinic, unable to get an appointment or have a needle phobia then our doctor can prescribe second line treatment that comprises of two different antibiotics that you take orally. As our treatment is second line, and therefore not considered to be as effective as the first line treatment, we provide a free “test of cure” that you can send to the lab 14 days after treatment to make sure you are clear of infection.

We will ask that you complete a simple medical questionnaire that our Doctor can assess for your suitability and, if approved, be prescribed the oral antibiotics to treat the infection.

Your treatment will be delivered in discreet, unmarked packaging with no mention of the contents or who it’s from. You can have your parcel delivered to your home or work address and, if in an area where we use DPD, you can have it diverted to a local pickup shop where you can collect it at your convenience.

The symptoms for all STIs are very similar and it’s better to get tested to find out which STI you may have rather than trying to guess from your symptoms. Then you can receive the most appropriate treatment and be sure of treating the infection successfully.

This is especially important for gonorrhoea as there is evidence of a resistant strain of gonorrhoea emerging in the UK and unnecessary prescribing of antibiotics can contribute to this.

References

  1. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)

  2. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/806118/hpr1919_stis-ncsp_ann18.pdf

  3. https://www.nhs.uk/conditions/gonorrhoea/symptoms/

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
11th June 2019

Tadalafil is much cheaper than Cialis

Posted 11 June 2019 in Erectile Dysfunction

Tadalafil vs CialisFor men who suffer from erectile dysfunction there is a product available called Cialis which is known as the “weekend pill”. (1) It performs the same function as Viagra in that it helps to maintain an erection, but Cialis lasts in the body for 36 hours so you can take the pill on Friday night and it will still be active on Sunday morning. This doesn’t mean that you will have an erection for that length of time but you will be ready for satisfactory sexual activity when you have been sexually aroused.

The active ingredient in Cialis is Tadalafil, and you can now buy generic Cialis under the name of Tadalafil which produces exactly the same effect. The big advantage is that it is much cheaper. You can buy Tadalafil 10mg and Tadalafil 20mg, the latter being the high dose. Tadalafil 10mg is the recommended staring dose, but this can be increased to 20mg if necessary if you find that it’s not as effective as you would like and you haven’t suffered from any side-effects.

You can also buy Tadalafil Daily online.  Tadalafil Daily is available in strengths of 2.5mg and 5mg. The lower dose takes 4 – 5 days to take effect, but once it has you will be able to respond to any sexual stimulation anywhere, at any time.

Tadalafil Daily tablets should be taken once a day and it’s best to take it at the same time of day. So it’s a good idea to stick to a regular time of day, like when you’re having your breakfast, so that you don’t forget. You are advised not to drink grapefruit juice when taking Tadalafil as this can affect the effectiveness of the pill. You should also not drink more than one or two units of alcohol before taking the medication because that can also affect your ability to get an erection. (2)

References

  1. Summary of Product Characteristics. Cialis 2.5mg, 5mg, 10mg & 20mg film-coated tablets. Eli Lilly and Company. Date of revision of the text: 03 September 2008. Accessed via http://emc.medicines.org.uk on 7/6/19 

  2. British National Formulary, 76th edition. Accessed via www.bnf.org on 7/6/19.

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
9th June 2019

Sildenafil vs Viagra

Posted 11 June 2019 in Erectile Dysfunction

Sildenafil vs ViagraSildenafil is a generic treatment for erectile dysfunction and today you can buy Sildenafil online which many men may find less embarrassing and more convenient than having to make a journey to their local pharmacy for it.

Sildenafil (the generic form of Viagra) and Viagra are medically identical, and so are found to be equally effective.

Both products contain the identical amount of active ingredient. (1)

Until 2013 nobody else could produce Sildenafil because Pfizer had a patent. However, that patent expired in 2013 and today other companies can manufacture Sildenafil. As you might expect, generic Sildenafil tablets are less expensive than Viagra even though they contain exactly the same ingredient and produce the same effect. This has enabled many more men to be able to enjoy a more fulfilling sex life.

The only difference between generic Sildenafil tablets and Viagra are the fillers. These are used to bulk up the tablets, since the amount of Sildenafil required in each is only tiny. Different manufacturers use different fillers and that is why the brands differ in shape, colour and size. (2) A commonly used filler is lactose. Those who are lactose intolerant should carefully check the Patient Information Leaflet supplied with their Sildenafil tablets before taking them. There is one brand which does not contain lactose and that is called Mylan.   Fortunately, Webmed Pharmacy only supplies the Mylan brand of Sildenafil.

Viagra contains lactose.

Sildenafil is usually sold in white or blue tablets, the blue being a form of identification with Viagra which is sold in blue diamond shaped pills. Pfizer has trademarked the shape of its pills which cannot be copied, but they cannot trademark the colour.

Both Sildenafil and Viagra are available in 25mg, 50mg, and 100mg tablets.

References

1) https://sciencebasedmedicine.org/are-generic-drugs-equivalent-to-brand-name-drugs/ (accessed on 7/6/19)

2) https://sciencebasedmedicine.org/whats-all-that-other-stuff-in-my-medicine/ (accessed on 7/6/19)

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
9th June 2019

Why do younger men suffer from erectile dysfunction?

Posted 28 May 2019 in Erectile Dysfunction

A frustrated young man in bed suffering from erectile dysfunction. Source medicalimages.comErectile dysfunction (ED) is a problem generally viewed in society as being associated with middle aged and elderly men. However, contrary to popular belief, ED can affect men of all ages, and does affect plenty of younger men. But why?

There are numerous physical and emotional factors which can cause or contribute to ED. Anxiety is a major contributor for younger men. You may worry that your partner is negatively judging your sexual performance, or that they won’t reach orgasm. You might fear that a partner will become pregnant. These anxious feelings may result in a stress response, directing blood away from the penis to other parts of the body, and therefore causing loss of erection. (1, 2)

ED in younger men may also be caused by anxiety or stress that is not directly related to sexual activity. Just a few examples of factors which can contribute to anxiety and stress are problems in the workplace, financial struggles, ill health (yourself or a relative or friend) or a rocky relationship. All of this can have an impact on ED. What’s more, ED can cause further anxiety, worsening the problem in a cruel spiral. (2)

If you smoke and suffer with ED, you may want to consider stopping as smoking is a major cause of the condition in many men, younger and older. The components of cigarette smoke can have a damaging effect on blood vessels, including those in the penis. One such effect is the formation of plaque on the walls of the blood vessels, known as atherosclerosis. This makes the area through which blood can flow narrower, impairing the surge in blood flow to the penis that is essential for an erection. Visit your GP for help getting started on your path to being smoke free. Alternatively, many pharmacies offer a smoking cessation service, with regular meetings with a member of staff to guide you through the quitting process. (2)

Alcohol can also be a culprit. In the short term, after a session of heavy drinking, the physiological response to sexual arousal can be sluggish or non-existent, causing an episode of poor erectile function. However, this should right itself once you sober up. In the long term, persistent binge drinking can damage the blood vessels of the penis, leading to ED. Stick to no more than 14 units of alcohol per week, and no more than 8 units in one drinking session. (2, 3, 4)

Being overweight or obese, particularly if you carry a lot of excess weight around the abdomen, puts you at higher risk of ED. Having a greater body mass means that your heart has to work harder to pump blood around your body and to your extremities, such as the tip of the penis. A diet high in fat and cholesterol can also lead to atherosclerosis, as with smoking. Aim for at least 30 minutes of moderate to intense exercise at least five times a week, and reduce or cut out high fat foods such as cheese, red meat, chocolate, cakes and biscuits, and fried foods. (5)

If you’re an avid cyclist or commute to work by bike, this can work wonders for your cardiovascular health and help to keep excess weight off. But did you know that cycling for over three hours per week can be a cause of ED? Prolonged or regular pressure on the pudendal nerve, which runs through the perineum (the area separating the genitals from the anus), can damage this nerve which plays a part in erectile function. You could consider supplementing cycling with other forms of exercise, or investing in a specialised saddle which is designed to ease pressure on the perineum. (3, 6)

Taking all of this into account, it really isn’t a surprise that younger men can experience ED. There are so many lifestyle factors and health conditions which affect men of all ages and can also contribute to ED. Don’t be embarrassed to seek a diagnosis and treatment – remember there are plenty of other men in your position and your doctor is there to help. If you don’t want to see your doctor initially, Viagra Connect (sildenafil) is available over the counter in pharmacies, subject to filling out a safety questionnaire. However, you’ll be strongly advised to see your doctor within six months of starting Viagra Connect, as it is important that your doctor knows which medicines you are taking on a regular basis, as well as to rule out any serious problems which may be contributing to your ED.

Viagra Connect is available to buy from Webmed, and the prescription only ED medicines Cialis (tadalafil), Spedra (avanafil), Levitra (vardenafil) and higher strength Viagra (sildenafil) are available to purchase here, as well as the generic sildenafil and tadalafil, after a quick medical questionnaire which is reviewed by a doctor.

References

  1. British Pregnancy Advisory Service. Erectile dysfunction (male impotence) [cited 24 May 2019. Available at: https://www.bpas.org/more-services-information/erectile-dysfunction/

  2. International Society for Sexual Medicine. Is erectile dysfunction (ED) common in men under age 40? [cited 24 May 2019]. Available at: https://www.issm.info/sexual-health-qa/is-erectile-dysfunction-ed-common-in-men-under-age-40/

  3. NHS. Erectile dysfunction (impotence) [cited 24 May 2019]. Available at: https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/

  4. NHS. Binge drinking [cited 24 May 2019]. Available at: https://www.nhs.uk/live-well/alcohol-support/binge-drinking-effects/

  5. The Telegraph (2018). ‘Does anxiety cause erectile dysfunction?’ [cited 24 May 2019]. Available at: https://www.telegraph.co.uk/health-fitness/living-with-erectile-dysfunction/does-anxiety-cause-erectile-dysfunction/

  6. Men’s Health. Is Your Bike Killing Your Boner? [cited 24 May 2019]. Available at: https://www.menshealth.com/health/a19539158/can-bicycles-cause-erectile-dysfunction/

Author
Gabby Gallaher MPharm

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
24th May 2019

May Bank Holiday opening hours and last order dates

Posted 20 May 2019 in Men's Health, Sexual Health, Womens health

A quick reminder that Thursday 23rd May 4pm is the last time to place an order for treatments and testing kits for guaranteed free delivery before May Bank Holiday.

Order on Friday 24th before 4pm and you can get delivery on Saturday 25th May for just £2, otherwise deliveries will be on Tuesday 28th May.

Any orders placed after 4pm on Friday 24th May will be processed and dispatched for delivery on Wednesday 29th May.

Our pharmacy will be closed from 5pm on Friday 24th May until 9am on Tuesday 28th May.

STI Testing

The testing Lab is open 365 days a year, but DPD and Royal Mail are closed on Bank Holidays and this determines when your sample arrives at the Lab.

The last day for you to post your sample to the Lab is Wednesday 22nd May, to get your test results before May Bank Holiday.

Don’t post any samples to the Lab from Saturday May 25th until the morning of Tuesday 28th May when normal service resumes.

Have a Great May Bank Holiday from all the team at Webmed!

Online Testing And Treatment For Gonorrhoea

Posted 14 May 2019 in Sexual Health

Stained cellsGonorrhoea is a sexually transmitted infection and can be caught by having unprotected sex with an infected person. It can affect both men and women. Symptoms do not appear until about 10 – 12 days after infection and some 50% of women and 10% of men are unaware that they have it, because there may be no obvious symptoms. This can lead to long term health problems and infertility. (1)

Symptoms in men are a burning sensation when urinating, pain in the testicles, a discharge from the penis that may be white, yellow, or green, and inflammation of the foreskin if present. In women there will also be a burning sensation when urinating, vaginal discharge which may be green or yellow, lower abdominal discomfort, bleeding after sex, and bleeding between periods. (1)

If you are concerned that you may have been at risk, you need to wait 14 days before taking a test because it may not be detected earlier. At Webmed Pharmacy we can supply test kits for both men and women. In all mainland UK except the Scottish Highlands and islands, the kits will be delivered the next working day by DPD in unmarked packaging. All other areas will receive their discreet parcels by Royal Mail special delivery the next working day. (2)

You then take your sample using the test kit and send it in a pre-paid envelope to The Doctors Laboratory in London. Results will be available 2 – 3 days later, and we will contact you by email or SMS to tell you that there is a message waiting for you in your secure inbox at Webmed Pharmacy.

If your test proves positive for gonorrhoea or chlamydia we will then ask you to complete a simple medical questionnaire online so that our doctor can assess you for your suitability and, if approved, can prescribe the oral antibiotics that you need to cure the infection. (3)

If you have already tested positive using a home test kit from another site or a clinic, you can still complete the online questionnaire and if approved our doctor can prescribe the oral antibiotics. You should then take another test in order to ensure that you are free of infection 14 days after gonorrhoea treatment online, and we supply a FREE test kit to you for this purpose.  

References

  1. https://www.nhs.uk/conditions/gonorrhoea/symptoms/

  2. https://www.nhs.uk/conditions/gonorrhoea/diagnosis/

  3. https://webmedpharmacy.co.uk/buy/gonorrhoea-treatment-kit

    Medically reviewed by
    Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
     14 May 2019

Fact or fiction? Clearing up myths and misleading information about STI's

Posted 7 May 2019 in Sexual Health

Mr Rochester at the clinic

Can you tell which STI you have from symptoms only?

No, at least in most cases. Many symptoms of different STIs overlap, such as unusual discharge, pain when urinating and soreness and swelling of the vulva in women or the head of the penis in men. (1) Some STIs do have their own specific symptoms, such as black powder in underwear with pubic lice, but it is also important to remember that not everyone with a particular STI will experience all of the symptoms, and some may have no symptoms at all! Furthermore, HIV and Hepatitis B don’t cause symptoms, other than a flu-like illness which may occur a few weeks after infection. All of this is why it’s important to get tested! (1, 2)

Is there a single treatment for all STI's?

No. There are certain STIs that are caused by bacteria, some are caused by viruses, and others are caused by parasites, so the same treatment won’t work for them all. Also, different STIs need to be treated for different lengths of time, ranging from just a week long course of doxycycline (an antibiotic) for some cases of chlamydia to lifelong treatment with a daily cocktail of antiviral drugs for HIV.

Can all STI's be cured?

No. As previously mentioned, people living with HIV need ongoing treatment with many different antiviral drugs to keep the level of the virus in their body as low as possible. Genital herpes, as with any other herpes virus, remains dormant in the body once contracted, undetectable by the immune system – and can flare up at any time, particularly during times of stress or ill health. Genital warts are caused by one of several human papilloma viruses (HPVs) which tend to remain in the skin, even if there are no visible warts present, and can cause flare ups – although in some people, the immune system may eliminate the virus eventually. (3)

Conversely, some STIs can be cured very easily with a simple course of antibiotics, such as chlamydia, gonorrhoea and trichomoniasis.

Can I catch an STI from kissing?

No. Still, beware of cold sores, which are caused by a type of herpes virus (usually a different strain to the genital herpes virus) – these can be passed on through kissing.

Can I catch an STI from a toilet seat?

No. STIs can’t survive outside of the body for more than a few seconds (an exception to this rule is Hepatitis B, which can survive outside the body for at least seven days - but it is not strictly classed as an STI due to there being several other ways to contract it). (4)

Can I get an STI again even if I’ve been treated before?

Yes. Courses of treatment for curable STIs are to treat the current infection and offer no protection against future infections. Likewise, your body cannot develop immunity to STIs.

Do I need a “test of cure” for all treatments?

No – only for gonorrhoea. For pubic lice, the affected area should be checked to ensure there are no live lice one week after treatment ends. However, for any STI that can be cured with a course of treatment, see your GP if symptoms persist after you have completed the course. (5, 6)

Are men or women more likely to catch an STI?

The proportions of men and women being diagnosed with the various different STIs vary based on the STI in question and also year by year. Several factors can affect how many men and women are diagnosed with STI's, including women tending to show fewer symptoms due to most of their genitals being internal and therefore less visible, and women being more likely than men to attend an STI test. STI's seem to disproportionately affect homosexual men, possibly due to less frequent condom use compared with the heterosexual population. (7)

I’m pregnant, will my baby be affected?

Many STIs can affect unborn babies during pregnancy or be passed to the baby during birth.

  • Chlamydia can cause premature birth or low birth weight. Transfer from mother to baby during birth can lead to conjunctivitis and pneumonia. (8)

  • Gonorrhoea can cause miscarriage or premature labour. The baby may contract the infection during birth and develop conjunctivitis (an eye infection). If this is left untreated or treatment is delayed, the child may suffer from permanent impaired vision or even blindness. (9)

  • Trichomoniasis may cause low birth weight and premature birth. (10)

  • Genital warts can occasionally infect babies during birth, leading to infection in either the throat or genitals. (3)

  • Genital herpes can cause neonatal herpes in the baby. This is a very serious infection and is potentially fatal, but it usually only develops if the mother contracts genital herpes while she is pregnant. (11)

  • Syphilis can cause serious complications during pregnancy, including miscarriage, stillbirth and syphilis infection in the baby (congenital syphilis). Routine testing for syphilis is available to all pregnant women in this country for this reason. (12)

If you are pregnant and are in doubt as to whether you may have an STI, consult your midwife or see your GP.

References

  1. NHS. Sexually transmitted infections (STIs) [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/sexually-transmitted-infections-stis/

  2. NHS. Pubic lice [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/pubic-lice/

  3. NHS. Genital warts [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/genital-warts/

  4. CDC.Hepatitis B Questions and Answers for the Public [cited 1 May 2019]. Available at: https://www.cdc.gov/hepatitis/hbv/bfaq.htm

  5. NICE CKS. Gonorrhoea [cited 1 May 2019]. Available at: https://cks.nice.org.uk/gonorrhoea#!scenario

  6. NICE CKS. Pubic lice [cited 1 May 2019]. Available at: https://cks.nice.org.uk/pubic-lice#!scenario

  7. FPA. Sexually transmitted infections factsheet [cited 1 May 2019]. Available at: https://www.fpa.org.uk/factsheets/sexually-transmitted-infections

  8. NHS. Complications: Chlamydia [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/chlamydia/complications/

  9. NHS. Complications: Gonorrhoea [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/gonorrhoea/complications/

  10. NHS. Trichomoniasis [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/trichomoniasis/

  11. NHS. Genital herpes [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/genital-herpes/

  12. NHS. Syphilis [cited 1 May 2019]. Available at: https://www.nhs.uk/conditions/syphilis/

Author
Gabby Gallaher MPharm

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
7 May 2019

Saxenda: the newest recruit into the battle against obesity

Posted 4 April 2019 in Weight Loss

Feet on weighing scales. Source: medicalimages.comObesity is a growing problem in the UK. A quarter of UK adults are obese, and this proportion could rise further with our increasingly sedentary lifestyles and readily available cheap, unhealthy food. With many of us moving less due to sitting at desks at work, getting around by car and spending more time on the sofa instead of up and about, we burn fewer calories. Combined with a higher calorific intake thanks to the generally lower cost and greater accessibility of unbalanced ready meals and fast food compared with fresh produce, this equates to weight gain. (1)

Most of us know that on a basic level, the key to losing weight is simply eating less and moving more, so that on a daily basis, calories taken in amount to less than calories burnt. But in reality, many factors can stand in the way of this change in lifestyle, including time constraints and lack of motivation. In addition, several medical conditions such as type II diabetes mellitus, pre-diabetes, polycystic ovarian syndrome (PCOS) and hypothyroidism, as well as certain medications, can make weight loss harder to achieve. That’s why medical intervention may sometimes be needed. (1)

Until recently, there was only one medication – orlistat – licensed to treat obesity in this country. Orlistat stops around a third of the fat in your diet being absorbed, helping to prevent weight gain. However, unpleasant side effects directly related to this mode of action include oily, loose stools, flatulence, urgency to pass stools more frequently than is normal for you, and an oily rectal discharge. (1)

What is Saxenda and how does it work?

The newest addition to the obesity treatment market is Saxenda, a brand of the medication liraglutide. Liraglutide was originally developed as an anti-diabetic drug and is licensed for this purpose under the name Victoza, at a different strength to Saxenda. Saxenda is available as a pre-filled pen for subcutaneous (under the skin) injection containing 18mg of liraglutide in 3ml of solution. (2)

Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist, meaning it acts at the receptor for GLP-1, an appetite-regulating substance naturally produced in the body. The way in which liraglutide interacts with the receptor is currently unclear. (2)

Saxenda is different from weight management products that you may have taken in the past. Saxenda makes you feel full and less hungry, which can help you eat less and reduce your body weight.  It can help you to not only lose weight, but keep it off as well.

Use the Saxenda pen at home or on the go

You can inject your dose in your stomach area (abdomen), upper leg (thigh), or upper arm.

Saxenda - self-injectable pen can be used in the upper arm, abdomen or thigh

Who can use Saxenda?

Saxenda is licensed to treat obesity in people with a body mass index (BMI) of 30kg/m2 or higher, or those with a BMI of 27kg/m2 to 30kg/m2 who have one or more of a number of weight-linked health conditions including type II diabetes mellitus, hyperlipidaemia (raised fat or cholesterol levels in the blood), high blood pressure and obstructive sleep apnoea. It should be used in combination with a reduced-calorie diet and regular exercise. (2)

Children and young people under the age of 18 should not use Saxenda, as it is not yet known how the drug affects this age group. Furthermore, Saxenda should not be used by pregnant or breastfeeding women due to unknown effects on the foetus or baby. (3)

What is the dose for Saxenda?

When starting Saxenda, the initial dose is 0.6mg daily, injected into the abdomen, front of the thigh or upper arm, but not into a vein or muscle. The dose is increased at least on a weekly basis by a further 0.6mg until the daily dose is 3mg, the maximum recommended daily dose. The reason for this gradual increase in dose is that gastrointestinal side effects, such as nausea, vomiting, diarrhoea and constipation are very common, especially at the beginning of treatment, so lower doses to start improve tolerability and make it more likely that the patient will continue treatment. If Saxenda is still intolerable two weeks after stepping up to the next dose, treatment should be stopped. (2)

How long before Saxenda starts to work?

Patients using Saxenda can expect to have lost at least 5% of their starting weight once they have been on 3mg daily for twelve weeks, given they have also been consuming fewer calories and increasing exercise. If this hasn’t been achieved, treatment with Saxenda should no longer be continued. (2)

What results have been seen with Saxenda?

Medical studies with more than 3,000 people taking Saxenda were conducted to understand the benefits and risks of Saxenda. The results from the study showed significant weight loss.

Along with a low-calorie meal plan and increased physical activity, some people lost nearly 2.5 times more weight with Saxenda versus placebo (17.3 lb vs 7 lb). Study participants had an average starting weight of 234 lb and an average BMI of 38. (3)

In a different 1-year study, most people who stayed on Saxenda kept the weight off. (3)

Can I use Saxenda alongside other medication?

If you take a type of medication for diabetes known as a sulfonylurea (such as gliclazide or glimepiride), the dose may need to be adjusted while you use Saxenda to reduce the risk of hypoglycaemia (low blood sugar). (4)

If you use Victoza for diabetes you should not use Saxenda at the same time. This is because they both contain liraglutide, so using them together will lead to overdose.

Patients taking warfarin or other anticoagulants may need to have more frequent tests to monitor how long it takes their blood to clot. (4)

Where can I find Saxenda?

Saxenda is usually only prescribed privately as the manufacturer does not intend for it to be promoted within the NHS. It will be available to purchase from Webmed Pharmacy in the near future, so watch this space! (5)

References

  1. NHS. Obesity – Overview [cited 24 March 2019]. Available at: https://www.nhs.uk/conditions/obesity/
  2. NICE. Obese, overweight with risk factors: liraglutide (Saxenda) – Product overview [cited 24 March 2019]. Available at: https://www.nice.org.uk/advice/es14/chapter/Product-overview
  3. Novo Nordisk. Saxenda [cited March 2019] https://www.saxenda.com/learn-about-saxenda/what-results-have-been-seen-with-saxenda.html
  4. emc. Saxenda 6 mg/mL solution for injection in pre-filled pen [cited 24 March 2019]. Available at: https://www.medicines.org.uk/emc/product/2313/pil
  5. NICE. Obese, overweight with risk factors: liraglutide (Saxenda) – Estimated impact for the NHS [cited 24 March 2019]. Available at: https://www.nice.org.uk/advice/es14/chapter/Estimated-impact-for-the-NHS

Author
Gabby Gallaher MPharm

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
4 April 2019

New therapy in the pipeline for Parkinson's disease?

Posted 14 March 2019 in Men's Health, Womens health

A brain scan showing substantia nigra in red. Source: medicalimages.comParkinson’s disease affects one in every 500 people, with symptoms beginning to show over the age of 50 in most cases, but for 5% of people with the condition, symptoms will first appear before the age of 40. It can have a devastating impact on a person’s quality of life, with movement, balance, memory, mental health and sleep all having the potential to be affected. Current treatment aims solely to ease symptoms and does not cure the condition. But a recent trial of an innovative therapy has hinted at new hope for those with Parkinson’s disease. (1, 2)

What is Parkinson’s disease?

Parkinson’s disease is a neurodegenerative disease involving damage and death of dopamine-releasing nerve cells in a region of the brain known as the substantia nigra, which regulates body movements. Dopamine is a neurotransmitter, which is a chemical which acts as a communicator between nerve cells. Therefore, the diminution in dopamine levels in the brain caused by the death of these cells reduces intercellular communication relating to movement and leads to tremor, sluggishness and stiffness. Symptoms do not usually show until only around a fifth of these nerve cells remain. (2, 3)

In addition to the primary movement symptoms, people with Parkinson’s disease can also experience a deterioration in mental health, difficulty keeping balance (and therefore greater risk of falling), insomnia, reduced sense of smell and poor memory. (2)

What is the outcome of the recent trial?

The results of a recent trial of a radical treatment for Parkinson’s disease have been released. The treatment, known as glial cell line-derived neurotrophic factor (GDNF), is an entirely new approach, administered via a ‘port’ that is embedded in the side of the patient’s head. This allows the drug to be delivered directly into the brain, where it then acts on dopamine nerve endings. (1)

Before the trial, the 35 participants had surgery which involved embedding four tubes into their brains. These tubes would be the route of administration of the drug into the brain, with the outer end being attached to the port where the drug would enter the tube. (1)

The trial lasted nine months, during which half of the participants were administered with a dose of GDNF every month, with the other half being administered a placebo infusion (containing no drug). For those given the drug, brain scans after the trial suggested that the progression of the disease had been significantly reversed. The average length of time since diagnosis for the trial’s participants was eight years, but the post-trial scans appeared to show features typical of brains just two years after diagnosis. This implies that GDNF can revitalise dying nerve cells and restore their function. (1)

However, it is too early to know whether GDNF will become a routine treatment at this stage – more trials involving larger numbers of participants, longer treatment courses and different doses will need to be performed before its licensing is considered. The placebo effect will need to be ruled out (this is when a participant being given a placebo experiences an improvement in their condition or symptoms). (1)

Regardless, it is very exciting that new modes of drug delivery such as this are being developed and tested. If successful, the approach may even be used to develop treatments for other conditions affecting the brain, including Alzheimer’s disease and brain tumours. (1)

References

  1. Therrien A (2019). ‘Radical Parkinson’s treatment tested in patients’, BBC News. Available at: https://www.bbc.co.uk/news/health-47370498

  2. NHS. Parkinson’s disease – Overview [cited 1 March 2019]. Available at: https://www.nhs.uk/conditions/parkinsons-disease/

  3. NHS. Parkinson’s disease – Causes [cited 1 March 2019]. Available at: https://www.nhs.uk/conditions/parkinsons-disease/causes/

    Author
    Gabby Gallagher MPharm

    Medically reviewed by
    Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 
    14/03/19

Sore throat: a real pain in the neck!

Posted 12 February 2019 in Men's Health, Womens health

A woman with a sore throat. Source: medicalimages.comAt this time of year, sore throats are just one of many ailments that become rife in the community. Most are caused by simple viral infections and will resolve on their own within a week or two. But it’s also useful to know in which instances you’d need to seek medical advice or treatment.

What can I do to help ease a sore throat?

When you first develop a sore throat, there are several self-care approaches that you can take to ease the symptoms while your body fights off the infection:

  • gargling with warm salt water (not recommended for young children due to the risk of swallowing)

  • resting (including resting your voice!)

  • getting plenty of fluids, but steering clear of hot drinks

  • avoiding rough, sharp, hot or acidic foods

  • sucking ice cubes, sweets or lollies (ice cubes and boiled sweets not recommended for young children as they pose a choking hazard)

  • avoiding smoking, including second-hand smoke (1)

What medication is available to buy to help a sore throat?

There are a number of medicines available on the shop floor and over the counter in pharmacies to help ease a sore throat, including:

  • ibuprofen (which is also an anti-inflammatory)

  • paracetamol (which can also help with any associated fever)

  • medicated or anaesthetic lozenges and anaesthetic sprays and mouthwashes, containing active ingredients such as flurbiprofen and benzydamine (anti-inflammatories), benzocaine (an anaesthetic), and amylmetacresol (a mild antiseptic) (1)

When should I see the GP for a sore throat?

Most sore throats will get better by themselves after a few days. However, if you find you experience any of the following, you’ll need to see your GP:

  • your throat is just as painful after a week of symptoms developing

  • recurrent sore throats

  • fever (feeling hot and shivery with a raised temperature)

  • you have a condition that weakens your immune system, such as diabetes

  • you are receiving treatment that weakens your immune system, such as chemotherapy (1)

A long-lasting and very painful sore throat can be a sign of infection with a type of bacteria called Group A Streptococcus (this condition is commonly known as strep throat). This will need treatment with a course of antibiotics. (1)

A recurrent or long-lasting sore throat can signify other underlying health issues, such as deficiencies and low levels of certain types of blood cells. Your GP can investigate this and ensure you get the appropriate treatment.

A long-lasting sore throat accompanied by hoarseness and coughing with no other symptoms can be indicative of throat cancer. That’s why it’s so important to see your GP if you experience this with no signs of improvement.

In the news: new pharmacy-based sore throat scheme

Over 30 pharmacies in North Wales are offering a new scheme involving the use of a questionnaire and potentially a swab test to determine whether a patient’s sore throat is bacterial or viral in origin. If a bacterial infection is present, then pharmacists who provide the Common Ailments Scheme (which encourages patients to visit a pharmacy before seeing their GP) will be authorised to supply the relevant antibiotics to treat the infection. If this is a successful service, it may eventually be rolled out across the country, giving the public greater and faster access to the sore throat treatment they need. (2)

References

  1. NHS. Sore throat [cited 28 January 2019]. Available at: https://www.nhs.uk/conditions/sore-throat/

  2. North Wales Pioneer. New sore throat test and treat service to be piloted in pharmacies across North Wales [cited 28 January 2019]. Available at: https://www.northwalespioneer.co.uk/news/17386085.new-sore-throat-test-and-treat-service-to-be-piloted-in-pharmacies-across-north-wales/

Author
Gabby Gallagher MPharm

Medically reviewed by
Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 
05/01/19

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