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Pharmacist consultation

Viagra Connect - Sidena Pharmacist Consultation

For: Viagra Connect Sildenafil 50mg Tablets 8 Pack

In order for our pharmacists to assess whether you can safely take Viagra Connect or Sidena, please complete the following 20 questions. All answers are strictly confidential.

It is recommended that all men starting this medication see their GP without delay and certainly within 6 months. This is to check that your symptoms of erectile dysfunction are not being caused by any underlying conditions.

The person intending to take this medication must be the person to complete this form.

Required before purchase

Consultation questions

A pharmacist may contact you before this item can be supplied. Fields marked with an asterisk are required.

Your details

These details help pharmacy staff match your answers to your request.

Health questions

Please answer honestly so a pharmacist can review the request safely.

  • Low blood pressure or uncontrolled high blood pressure
  • Unstable angina (chest pain), irregular heartbeat or palpitations (arrhythmia)
  • A problem with one of the valves in your heart (valvular heart disease)
  • A problem where the heart muscle becomes inflamed and does not work as well as it should (cardiomyopathy)
  • Heart problems causing blood flow issues, e.g. left ventricular outflow obstruction, aortic narrowing, or severe cardiac failure
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