Medical Assessment

Have you ever been diagnosed with malaria?

Error We are unable to prescribe you this medication.

For further information kindly contact our patient support team:

Phone 0207 867 3932

Email email help@clickpharmacy.co.uk.

Have you checked with the website fitfortravel.nhs.uk/destinations to ensure that the malaria tablets you have chosen are suitable for the countries you are visiting?

Error We are unable to prescribe you this medication.

For further information kindly contact our patient support team:

Phone 0207 867 3932

Email email help@clickpharmacy.co.uk.

Are you pregnant or breastfeeding or may become pregnant or start breastfeeding whilst taking this medication?

Error We are unable to prescribe you this medication.

For further information kindly contact our patient support team:

Phone 0207 867 3932

Email email help@clickpharmacy.co.uk.

Do you suffer from any of the following?

  • Depression, thoughts about suicide or any other mental problem;
  • Fits (seizures or convulsions);
  • Heart problems, especially changes in heart rhythm;
  • Blood or lymphatic disorders;
  • Severe kidney or liver problems;
  • Myastenia gravis (type of muscle weakness);
  • Alcohol dependence;
  • Systemic lupus erythematosus (SLE);
  • Liver or kidney problems;
  • Asplenia (absence of normal spleen function);
  • Acute porphyria (blood disorder);
  • Galactose or fructose intolerance-severe kidney disease;
  • HIV;
  • Any other chronic condition that we should know about;
Error We are unable to prescribe you this medication.

For further information kindly contact our patient support team:

Phone 0207 867 3932

Email email help@clickpharmacy.co.uk.

Are you taking any of the following medication?

  • Halofantrine;
  • Heart disease or high blood pressure medication;
  • Mental health medication (psychiatric disorders);
  • Epilepsy treatment;
  • Blood clotting disorders or diabetes medication;
  • Anticoagulants such as warfarin;
  • Cholesterol medication such as atorvastatin or simvastatin;
  • Antiepileptics such as carbamazepine, phenytoin or sodium valproate;
  • Rifampicin, rifabutin (antibiotics);
  • Methotrexate;
  • Metoclopramide;
  • Oral typhoid vaccine;
  • Strontium ranelate (for ostheoporosis);
  • Fluconazol, itraconazol;
  • Penicillins such as flucloxacilin;
  • Retinoids including but not limited to isotretinoin;
  • Other tetracycline antibiotics such as oxyteracycline;
  • Metoclopramide (to treat nausea);
  • Efavirenz or other medicines to treat HIV;
  • Etoposid (for cancer treatment);
Error We are unable to prescribe you this medication.

For further information kindly contact our patient support team:

Phone 0207 867 3932

Email email help@clickpharmacy.co.uk.

Are you taking any other medication not listed above?

Error We are unable to prescribe you this medication.

For further information kindly contact our patient support team:

Phone 0207 867 3932

Email email help@clickpharmacy.co.uk.

Are you allergic to mefloquine hydrochloride, atovaquone, proguanil hydrochloride, doxycycline, tetracyclines or to any of the ingredients in the anti-malaria medication (such as lactose)?

Error We are unable to prescribe you this medication.

For further information kindly contact our patient support team:

Phone 0207 867 3932

Email email help@clickpharmacy.co.uk.

Are you aware and agree to the following?

  • No malaria tablet will provide you 100% protection against malaria infection and you should use other protective methods as well (DEET repelents, protective clothing...);
  • Not to take any indigestion remedies such as antacids, calcium, iron, aluminium, magnesium and zinc containing medicines at least 2 hours before or after taking doxycycline;
  • To avoid sunlight and sun lamps while taking doxycycline;
  • To discontinue the treatment and seek medical help if you start experiencing headache, visual distrubance or any unusual skin reaction;
  • Lariam can cause dizziness, do not drive or operate heavy machinery if Lariam affects you.;
  • Lariam may cause serious mental problems in some people. Tell your doctor immediately if you experience any symptoms.;
Error We are unable to prescribe you this medication.

For further information kindly contact our patient support team:

Phone 0207 867 3932

Email email help@clickpharmacy.co.uk.

Are you aware and agree to the following?

  • You answered thrutfully to all the questions and you are aware that any incorrect information you provided might present a danger to your health;
  • The treatment is solely for your own use;
  • You will read the patient information leaflet supplied with your medication;
  • To seek immediate medical attention if you develop any kind of illness after returning from your travel or up to one year after returning and mention your travel to malaria exposed area;
  • If you are currently taking an oral contraceptive pill, you should use at least one other method of protection while taking doxycycline and 7 days after finishing the course;
Error We are unable to prescribe you this medication.

For further information kindly contact our patient support team:

Phone 0207 867 3932

Email email help@clickpharmacy.co.uk.

Please tick the boxes to confirm the following:

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Order before 15:00pm (Monday to Friday) for next day delivery