February 2019: Public Health England’s antimicrobial prescribing guidance no longer recommends fluoroquinolones (ciprofloxacin) for standby treatment of travellers’ diarrhoea, due to increasing resistance to these antibiotics in some parts of the world.
National Institute of Health and Care Excellence (NICE) and Public Health England recommends standby azithromycin for patients at high risk of severe illness should they develop travellers’ diarrhoea or those visiting high-risk areas.
As a result Dr Fox has withdrawn supply of ciprofloxacin for travellers’ diarrhoea, and provides the recommended alternative azithromycin only.
Actavis UK & Ireland rebranded to become Accord Healthcare in 2017, and has now discontinued Actavis Aindeem branded generic finasteride 1mg (packs of 28 and 84 tablets). This has had a knock-on effect on UK supplies of other finasteride 1mg brands, as not all manufacturers offer the 84-tablet pack size, creating further demand on the smaller 28-tablet pack sizes.
The new EU Falsified Medicines Directive is also now in effect (February 2019) and the new packaging requirements has also contributed to production delays.
Index Medical Ltd is registered with the Care Quality Commission (CQC). Following an inspection 16 April 2019 by a team from the CQC the final report was published 04 June 2019 which rated the service ‘Good’ on all 5 aspects of the inspection framework:
Keeping it simple, tadalafil lasts for 36 hours and sometimes longer, and has the longest duration of action of all the PDE5 inhibitors. This compares for example to sildenafil (Viagra) which lasts for around 4 hours.
In addition, absorption of tadalafil is not affected by food, so it can be taken at any time before, during, or after a meal.
Tadalafil is a drug used to treat erectile dysfunction. It is a type of PDE5 inhibitor. Tadalafil is a generic or drug name – ‘Cialis’ is a branded form of tadalafil.
36 hours – really?
Yes, although this does not mean a continuous erection for 36 hours. Like all PDE5 inhibitors, tadalafil requires sexual stimulation to work – ie: you only get an erection when you want to.
Tadalafil is the medical – or generic – name for the Cialis brand of erectile dysfunction medicine. Tadalafil works in the same way as sildenafil (Viagra), however whereas sildenafil lasts for around 4 hours, tadalafil remains active for up to 36 hours, hence why it is sometime called the weekend pill. This does not mean you will have an erection for 36 hours, only when required, eg: when sexually aroused.
Most men take tadalafil as and when they need it 30 minutes or more before sexual activity. The usual starting dose is tadalafil 10mg, which – depending on effectiveness – may be increased to 20mg or decreased to 5mg.