Consultation

Aknemycin Plus

A prescriber reads every answer. Answer honestly: a wrong answer here is not a shortcut, it is the thing that makes a medicine unsafe for you.

1About your health
2About this treatment
3About you

Allergies

Do you have any allergies to medicines? * Yes No I am not sure

Which medicines, and what happened? *

Current Medications

List any medicines you take, including anything you buy without a prescription. *

Medical History

Are you being treated for any long-term condition? * Yes No

Which conditions? *

When was your last review? *

If you have diarrhoea or vomiting your pill may be less effective so you should get in touch with a medical professional (eg your online doctor or GP) about what to do. * Yes

I agree that I will contact my GP if I have any questions about this pill. * Yes

Have you or your family ever had a DVT/PE (Pulonmary Embolism), blood clot? * Yes No

Have you had any major surgery in the last 3 weeks? * Yes No

Please provide details of your migraines, such as when your last attack was *

Do you have migraines with aura (visual disturbances, numbness, or speech difficulties)? * Yes No

Have you or anyone in your family ever had a blood clot? * Yes No

Do you have mild or moderate acne? * Yes No

Are you female and between 18 and 55? * Yes No

Do you have inflammatory bowel disease, eg ulcerative colitis, crohns disease, or any other form of colitis? * Yes No

Are you using any other treatments for acne? * Yes No

Do you take any oral antibiotics? * Yes No

Do you have a history of ulcerative colitis or severe enteritis or colitis? * Yes No

Please provide more information on your enteritis/colitis. *

Do you take any treatment to treat your acne? * Yes No

What Do you use to treat your acne? *

Have you experienced any side effects from the treatment you are taking? * Yes No

Do you have moderate acne with inflamed spots, pustules or widespread acne affecting the face, chest or back? * Yes No

Are you aged 18 or over? * Yes No

Do you take any oral antibiotics for acne or another infection? * Yes No

Have you used lymecycline, oxytetracycline, doxycycline, minocycline or another oral antibiotic for acne in the last 3 months? * Yes No

What antibiotics have you used? *

To avoid antiboitic resistance, antiboitics are usually prescribed for a maximum of 3 months, before a treatment break. We need to understand when you started this cyle of antibiotics. What date did you start your first dose of this cycle? *

Are you using any other acne treatments, if so can you provide the name, strength and dose of what you are using? *

What is your skin type/tone? (e.g. oily, dry, sensitive, combination) *

How does the acne manifest itself? * Whiteheads Blackheads Nodules

Does your skin scar when healing? * Yes No

Do you have any other skin conditions such as eczema, psoriasis, rosacea, couperose dermatitis or cutaneous epithelioma? * Yes No

Please provide more information on your other skin condition(s). *

Please provide more information. *

Which areas of your skin are affected by acne? *

Lifestyle

Do you smoke? * Yes No

How many cigarettes do you smoke per day? * Fewer than 15 a day More than 15 a day

Have you ever smoked? * Yes No

Which of the following symptoms do you have?Acne symptoms:Blackheads or whiteheadsInflamed spots, pimples or pustulesPainful lumps, nodules or cystsAcne affecting the face, chest, back or shouldersAcne that is widespread, painful, inflamed, or causing scarringRosacea symptoms:Persistent facial rednessFacial flushingVisible small blood vessels on the faceBurning, stinging or sensitive facial skinSpots or pustules mainly affecting the cheeks, nose, chin or foreheadSymptoms triggered by heat, alcohol, spicy food, exercise or sunlight * Acne symptoms only Rosacea symptoms only Both acne and rosacea symptoms None of the above I am not sure

Current Medications

Do you take, or have you recently taken, any medicines that may affect hormonal contraception, including epilepsy medicines, tuberculosis medicines, HIV medicines, hepatitis C medicines, griseofulvin, St John’s Wort, lamotrigine, ciclosporin, theophylline, tizanidine, ulipristal, or tirzepatide/Mounjaro? * Yes No

Can you confirm you understand the following essential safety advice for Adapalene topical?Use Adapalene topical exactly as prescribed and only on the areas directed.Avoid eyes, broken skin and sensitive areas unless specifically instructed; wash hands after applying unless treating hands.Do not use potent steroids such as clobetasol/betamethasone/mometasone for longer, more frequently, or over larger areas than advised because this can thin skin and cause side effects.Seek advice if the skin becomes infected, painful, swollen, blistered, very irritated, or fails to improve.For acne/rosacea products, use sun protection if your medicine makes skin more sensitive/irritated, and avoid pregnancy where contraindicated such as topical retinoids. * Yes No

Do you take, or have you recently taken, any of the following medicines or supplements?Isotretinoin or any other oral retinoid, including acitretin, alitretinoin or tretinoin capsulesAnother oral antibioticTopical antibiotic acne treatments, including clindamycin, erythromycin, Duac, Treclin, Zineryt or Acnecide ClindamycinAntacids or indigestion remediesIron, zinc, calcium, magnesium, aluminium, bismuth or multivitamin supplementsSucralfateWarfarin or any other blood thinnerMethotrexateLithiumDigoxinCiclosporinEpilepsy medicinesOral cholera vaccine, or are you due to receive an oral cholera vaccine * Yes No

Allergies

Are you allergic to any of the following:AdapaleneAzelaic AcidBenzoyl PeroxideClindamycinTretinoinPropylene Glycol * Yes No

Do you have, or have you ever had, any of the following medical conditions?You have previously had an allergic reaction to lymecycline, tetracycline, doxycycline, minocycline, or any other tetracycline antibioticYou have kidney diseaseYou have liver diseaseYou have lupus / systemic lupus erythematosus (SLE)You have myasthenia gravisYou have raised pressure in the brain / intracranial hypertensionYou have papilloedemaYou have severe or unexplained headachesYou have visual disturbance, blurred vision, double vision, or loss of visionYou have severe acne with painful nodules, cysts, scarring, or rapidly worsening symptoms * Yes No

Can you please confirm you have read and understand the following?Apply a pea-sized amount once daily at bedtime to the entire acne-affected area, not just individual spots.Avoid contact with the eyes, mouth, nostrils, broken skin and areas affected by eczema. Wash your hands after applying.Dryness, redness, peeling, burning or irritation can occur, particularly when starting treatment. Use a gentle moisturiser and speak to your prescriber if irritation becomes severe.Treclin can make your skin more sensitive to sunlight. Use sunscreen, avoid sunbeds and limit prolonged sun exposure.Avoid using abrasive cleansers, scrubs, waxing products or other irritating acne treatments unless advised by your prescriber.Stop using Treclin and seek medical advice if you develop severe or persistent diarrhoea, abdominal cramps, or blood or mucus in your stools.Do not use Treclin if you are pregnant, think you may be pregnant or are planning a pregnancy. Stop treatment and contact your prescriber if you become pregnant.Seek urgent help if you develop facial swelling, difficulty breathing or a severe blistering or widespread skin reaction.Improvement may take several weeks. Do not use more than prescribed, as this will increase irritation rather than improve results faster. * Yes No

Your answers are seen by the prescriber reviewing your order and the dispensing pharmacist. They are not used for marketing.