Questions to Ask Your Pharmacist About ED Medicine

Pharmacists are the most available health professional in Australia — no appointment, no fee for a conversation, and a specialist knowledge of medicines and their interactions. In this category they are also the least used, because most people want to complete the transaction and leave.

That is a missed opportunity, and a simple one to fix. Here are the questions worth asking, and what each is really for.

Ask for a private word

Every community pharmacy has a consultation area or a quiet corner. Asking whether there is somewhere private to talk takes one sentence and changes the whole interaction. Pharmacists offer this routinely and think nothing of it.

Does this interact with anything else I take?

Yes, potentially — several common medicine classes interact seriously with ED medicines, which is why it is worth bringing a complete list: prescription medicines, over-the-counter products, supplements and herbal products included.

Specifically make sure the pharmacist knows about:

• Any nitrate. Glyceryl trinitrate spray, patch or tablet, isosorbide mononitrate or dinitrate, or nicorandil. Nitrates are an absolute contraindication with this class of medicine, and the combination can cause a severe fall in blood pressure. This includes a spray you carry but rarely use.
• Recreational nitrites, known as poppers, which fall under the same absolute contraindication.
• Alpha-blockers, whether prescribed for blood pressure or for prostate symptoms such as tamsulosin. These require particular care because of additive blood pressure effects.
• Antifungals, macrolide antibiotics and HIV medicines, some of which change how the body clears these medicines.
• Anything new since your last dispensing, including short courses from another prescriber.

What side effects should I expect, and which ones are serious?

Ask the pharmacist to separate the common and self-limiting from the ones that require action. You should leave knowing that chest pain or breathlessness during or after sexual activity, an erection lasting more than four hours, and sudden loss of vision or hearing all require urgent medical attention rather than a wait-and-see approach.

Does anything about my other health conditions matter here?

Significant cardiovascular disease, recent heart attack or stroke, uncontrolled blood pressure, severe liver or kidney impairment, a previous episode of sudden vision loss, retinitis pigmentosa, sickle cell disease and conditions predisposing to prolonged erection are all relevant. Your pharmacist will check these against your record and refer you back to your prescriber if something needs review.

Does food or alcohol affect this?

Sometimes, and it depends on the specific product you have been prescribed. Alcohol in particular affects both blood pressure and sexual function, and is worth discussing honestly rather than guessing.

Is this the same as what I had last time?

Useful when the box or tablet looks different. Brand substitution is permitted in Australia unless the prescriber has indicated otherwise or you ask to stay with a particular brand, and different manufacturers use different shapes, colours and markings.

Follow-up questions worth asking: is the active ingredient and strength identical, is the product on the ARTG, and does this brand contain anything I have reacted to before, such as lactose.

How much will it cost, and is there a cheaper equivalent?

Cost is a legitimate clinical issue, because people who cannot afford a medicine stop taking it. Ask about the total price including any dispensing fee, whether a generic equivalent exists, and whether the item is PBS-subsidised or a private prescription. Pharmacists deal with this daily and will not be offended.

How should I store it?

Below 25°C, away from direct heat and humidity — particularly relevant in the Australian climate. Ask about temperature, humidity, and whether to keep tablets in the blister. Never store medicines in a car.

What if I have a question later?

Ask how to reach the pharmacy with a follow-up question, and request the Consumer Medicine Information leaflet if it is not in the pack. Your pharmacist can print one.

Can you check whether a product is genuine?

If you have obtained something elsewhere and are unsure about it, a pharmacist can check whether it corresponds to a product on the ARTG and advise you. Bring the packaging.

This is worth doing rather than taking a chance. Sildenafil, tadalafil, vardenafil and dapoxetine are Schedule 4 prescription-only medicines in Australia requiring a valid prescription from a registered Australian prescriber, and the TGA has warned that products supplied outside that framework may contain the wrong ingredient, the wrong amount, or contaminants.

What the pharmacist cannot do

They cannot supply a prescription-only medicine without a valid prescription, and they will not diagnose the cause of your symptoms. What they can do is check safety, explain the medicine, flag anything that warrants going back to your prescriber, and answer questions without an appointment.

A short checklist for the counter

• Everything I take, in writing or photographed.
• Any nitrate, however occasional.
• Allergies and intolerances.
• Existing conditions, particularly cardiac.
• What to do if something goes wrong, and who to call.

Two minutes of questions at the counter is the cheapest safety check available. The Australian Commission on Safety and Quality in Health Care and Healthdirect Australia publish independent medicine information if you want to read further, and your GP or pharmacist remains the right place to raise anything specific to you.

This article is general information about using pharmacy services, not medical advice. Speak with your doctor or pharmacist about your own medicines.