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by James Thomas, Friday, 17 November 2017 | Categories: Cialis

The Online Clinic is pleased to announce that we are able to offer a generic version of Cialis at a significantly reduced price.

Tadalafil has been one of the most popular treatments for erectile dysfunction because of its relatively long half-life, allowing men more spontaneity than with other erectile dysfunction treatments. Up until now, we have had to prescribe this medication as Cialis as it was still on patent.

Tadalafil as a generic is only available at the 10 mg and 20 mg (on demand doses). If you are using Cialis as a daily medication then we will still have to prescribe as branded Cialis.

If you are already receiving ED medication from The Online Clinic then you can login to request a review of your treatment. If you have not used us before, you can register below.

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by James Thomas, Thursday, 16 November 2017 | Categories: General Health

Antibiotics: Mixed Messages for Patients

Scientific discoveries are happening all the time, and sometimes a new piece of research will come along to dispel everything we thought we knew.

The most recent debate to crop up regards antibiotic resistance. All approved guidance currently relating to antibiotic use tells us that finishing a course of antibiotics is vital, even if we begin to feel better within a couple of days. Now, experts have begun to argue something very different.

A team of UK researchers published a short opinion piece in the BMJ (formerly the British Medical Journal) in July, claiming that there is not enough evidence to suggest that cutting short a course of antibiotics contributes to antibiotic resistance.

One of the researchers, Professor Martin Llewelyn, suggested that long courses were "outdated" and that there is now plenty of evidence that short courses of three to five days work just as well. In his opinion, antibiotics should be prescribed on a case by case basis, tailored towards each patient and their specific infection, and not simply administered in the same way every single time.

While these researchers are not putting forward the idea that patients be allowed to judge themselves when they stop a course, there is concern amongst the medical community that this sort of guidance could end up causing confusion.

Not enough research has been done into the "stop when you feel better" model of antibiotic use, and for that reason Public Health England has recommended that patients continue to follow the advice of their prescribing doctor.

Correct Antibiotic Use

As well as taking the full course of antibiotics that you have been prescribed (whether or not you begin to feel better before the end of the course), there are a few things you can bear in mind if you wish to avoid contributing to antibiotic resistance.

The first thing to know is that antibiotics are only an appropriate treatment in the case of a bacterial infection. They have no effect upon viral infections. The common cold and flu are two types of viral infection, which cannot be treated with antibiotics. 

If you become unwell with a cold, you may be tempted to visit your doctor and ask for antibiotics, but it is always best to wait the infection out, resting at home and taking over-the-counter cold treatments. You should typically only visit your GP if your cold has not cleared after three weeks, or if the symptoms are getting noticeably worse.

The flu tends to be more serious, and you should visit your doctor if you fall into a certain at-risk group such as being over 65 or pregnant. Bear in mind, however, that antibiotics are not an appropriate treatment for the flu, and that the best way to avoid it if you are in an at-risk group is to get the annual flu jab.

Avoiding Infection

If you want to avoid taking antibiotics, one of the best things you can do is to protect yourself against bacterial infections. You can prevent germs from spreading by following the kinds of hygiene tips set out by the NHS here.

Another way to avoid infection is to always practise safe sex. Many STIs are bacterial, which means they should be treated with antibiotics. The problem is that STIs such as gonorrhoea have begun to develop antibiotic-resistant strains, which can be very difficult to treat.

To avoid STIs, you should always:

  • Use condoms during penetrative sex when you aren’t sure your partner is free from infection
  • Use dental dams and condoms during oral sex
  • Avoid sharing sex toys unless they have been cleaned or covered in a new condom

You can read more about the risks associated with specific sexual activities here.

Remember that it’s important to get tested regularly if you’re engaging in any risky sexual behaviours. Getting diagnosed early makes treatment easier and reduces the risk of complications; it will also stop you from passing the infection on to others.




by James Thomas, Thursday, 16 November 2017 | Categories: Mens Health

What Men Need to Know About Prostate Cancer

Since 2003, the Movember Foundation has spent the eleventh month of every year raising awareness for a variety of men’s health issues. In that time, over £400 million has been raised and gone into the funding of over 1,000 different projects looking into issues such as testicular cancer, mental health and prostate cancer.

Prostate cancer is the most common cancer in men in the UK; around 40,000 new diagnoses are made every single year. Though the survival rate for prostate cancer is good (around 84% of men will survive for ten years or more), it’s still a huge health concern for British men. Diagnosis can often be delayed for many years, as symptoms do not always develop in the disease’s early stages, and those who survive can be affected by a number of unpleasant side effects.

In honour of Men’s Health Awareness Month, we’ve put together a guide to prostate cancer. If you’re concerned about your prostate health, or the prostate health of someone you love, read on.

The Causes of Prostate Cancer

No one precise cause for prostate cancer has been established, but there are some risk factors to be aware of. These include:

  • Age: the older you get, the more likely you are to develop prostate cancer (most cases occur in the over-50s)
  • Family history: having close family members who suffered from prostate cancer can be a risk factor
  • Ethnicity: if you are of Afro-Caribbean or African descent, you have an increased likelihood of developing prostate cancer
  • Lifestyle: if you are obese and/or you don’t exercise regularly you are more likely to develop prostate cancer

Lowering your Risk of Prostate Cancer

While you cannot alter your age, family history or ethnicity, knowing that you are high-risk for prostate cancer will typically help with early diagnosis (in the event that you develop the disease).

Men who are not of African descent and who have no family history of prostate cancer may want to speak to their GP about their risk once they hit 50. Men who are of African descent, or who have a family history of prostate cancer, should usually start to talk to a doctor about their risk a few years earlier – normally at around 45. Early diagnosis will usually make treatment easier and more successful.

To mitigate your risk you can also try practising a healthy lifestyle. Try to take regular exercise (the NHS recommends 2.5 hours of moderate exercise, or 75 minutes of more vigorous exercise a week, as well as strength exercises two days a week) and eat a healthy, balanced diet that is low in saturated fat, sugar and salt.

Symptoms of Prostate Cancer

Prostate cancer doesn’t always cause symptoms in its early stages, but it’s still a good idea to familiarise yourself with some of the indications of the disease. Symptoms can include:

  • Needing to urinate more frequently, particularly during the night
  • Difficulty in beginning to urinate, and maintaining urination
  • Weak flow of urine
  • Feeling that your bladder has not totally emptied when you have finished urinating

These symptoms do not necessarily point to cancer – many men experiencing trouble urinating as they get older, often as a result of benign enlargement of the prostate – but it's worth visiting a doctor.

When prostate cancer spreads it can cause other symptoms such as loss of appetite, testicular pain, unexplained weight loss, and pain in the back. Again, none of these symptoms is specific to prostate cancer, but you should visit your doctor if you are experiencing any of them.

Diagnosing and Living With Prostate Cancer

Diagnosing prostate cancer can be tricky, and normally involves a few different tests. You will usually have to give a urine sample, a blood sample, and have your prostate examined by the doctor.

Treatment will depend upon the nature of the cancer, and your age and general health. In some cases, living with prostate cancer will require the treatment of the disease’s side effects.

The good news is that our understanding of prostate cancer is improving all the time, and that there are many resources available to support men with the disease. Learn more by visiting Prostate Cancer UK or talking to your doctor.




by James Thomas, Tuesday, 10 October 2017 | Categories: Skin and Nails

NICE Begins Approval Process for New Treatment for Severe Psoriasis

Draft guidelines that back the use of Almirall’s new product Skilarence, for the treatment of moderate or severe plaque psoriasis by the National Health Service in the United Kingdom, have been issued by the National Institute for Health and Care Excellence (NICE). The drug is being recommended for use by the Institute only in those adults who have the severe form of the disease or are unable to take, or have failed to respond to, different systemic non-biological treatments.

Psoriasis: What is it?

There are a number of different kinds of psoriasis, with most people only having one at any particular time, although it is possible for two different kinds to strike at once. Some can actually change into a different type, or end up becoming more serious. The great majority of psoriasis cases go through cycles, often causing difficulties for sufferers for several weeks or months but then stopping or easing. If you believe you may be suffering from psoriasis then you should see your GP or start a consultation here.

Psoriasis types

The most common type of psoriasis is plaque psoriasis, which presents with symptoms such as red, dry skin lesions that are covered with silver scales. These lesions are referred to as plaques and generally materialise on the elbows, scalp, lower back and knees but can actually appear anywhere on the body. These plaques can be sore or itchy or sometimes both, and the skin around joints may bleed and crack in severe cases.

Another form of psoriasis is scalp psoriasis, which can only appear on the scalp and in some cases may even cover the whole area. This form of psoriasis results in red skin patches that are covered with silvery-white thick scales. In some cases the patches cause no discomfort, but some people can find them extremely itchy. Hair loss can be the result in extreme cases, but this is normally a temporary effect.

Fifty percent of people afflicted with psoriasis develop nail psoriasis, which as the name suggests affects the nails. Tiny pits or dents can develop in the nails, and they may grow in an abnormal manner or become discoloured. Nails may also loosen from the nail bed and in severe cases crumble.

Gutatte psoriasis results in small drop-shaped sores appearing on the arms, legs, scalp and chest, and sometimes develops following a streptococcal throat infection. Many cases disappear in a couple of weeks but sufferers can go on to develop plaque psoriasis. It is particularly common in teenagers and children.

Inverse psoriasis affects the creases or folds of the skin, such as underneath breasts, between buttocks and around the groin and armpits, resulting in smooth, large red patches. Sweating and friction worsen the condition, making it particularly irritating during hotter weather.

Other, less common forms of psoriasis include pustular psoriasis, where blisters filled with pus appear on the skin; generalised pustular psoriasis, which also causes blisters and can cause chills, fatigue, fever and weight loss; palmoplantar pustular psoriasis, where pustules appear on the soles of the feet and the palm of the hands; acropustulosis, where pustules materialise on toes and fingers; and erythrodermic psoriasis, a very rare form where all the body’s skin can be affected, causing intense burning or itching and sometimes resulting in additional problems such as dehydration, hypothermia, malnutrition, infection and even heart failure.

The recommendation

The National Institute for Health and Care Excellence says that the results of clinical trials have demonstrated that Skilarence, otherwise known as dimethyl fumarate, is able to improve severe cases of psoriasis more than is the case with placebos. However, it is less effective in indirect comparison with systemic biological therapies as well as apremilast, otherwise known as Celgene’s Otezia. The drug’s incremental cost ratio, followed up with best supporting care, falls into the threshold of what is deemed a cost-effective use of the resources of the NHS in this setting, being £23,115 per QALY gained, in comparison with just best supporting care on its own. 

The recommendation also comes with a further condition, that the Skilarence treatment should be halted after sixteen weeks in the event of an inadequate response. This is defined as a reduction of 75 percent in the PASI score from the commencement of treatment, or a reduction of 50 percent in the same score, coupled with a reduction of five points within the Dermatology Quality of Life index. An estimated 951,000 people in the whole of England suffer from psoriasis, with 90 percent of those suffering from plaque psoriasis.




by James Thomas, Tuesday, 10 October 2017 | Categories: Weight Loss

Saxenda: The UK’s New Weight Loss Injection

In January of this year, a new weight loss treatment was quietly approved for use in the UK. Branded under the name Saxenda, this treatment contains the active ingredient liraglutide, and works by making you feel full and satisfied, thereby curbing food cravings.

Previously, liraglutide was only licensed for use as a diabetes treatment. Under the brand name Victoza (and in lower doses) it can be prescribed to people with type 2 diabetes to help them maintain a healthy blood sugar level. When it was discovered that patients were losing weight as a result of taking Victoza, researchers began to explore the potential of liraglutide as a safe weight loss treatment.

Since Saxenda was officially approved for this use in the UK, the treatment has steadily grown in popularity. In August, the Daily Mail published a profile on a UK businesswoman called Caroline Balazs. As explained in the article, Balazs, an aesthetic specialist, has found success with using liraglutide for weight loss and is one of a handful of practitioners in the UK making it available to her patients under the label SkinnyJab Clinics.

With many people likening the treatment to Botox, it’s expected that Saxenda will grow in popularity. But the question is: does it actually work?

How Saxenda Works

Saxenda works by mimicking a hormone made in the intestines called GLP-1 which helps you feel full after eating. In essence, it decreases your hunger and need to eat. This action assists in weight loss, particularly in conjunction with exercise and a healthy diet.

In one clinical trial, it was found that more than 60% of patients lost at least 5% of their weight while taking Saxenda; 31% lost more than 10%. Saxenda has also been shown to reduce blood pressure and lower your risk for cardiovascular disease.

Taking Saxenda Safely

Saxenda is designed for use by people with a BMI over 30, or over 27 if the patient also suffers from a weight-related issue such as high blood pressure. It should be administered once a day, starting with a low dose and building up to a higher dose each week. The treatment is designed to be injected subcutaneously (i.e. under the skin) and is normally administered in the abdomen, thighs or upper arm.

Common side effects of Saxenda include nausea, vomiting, diarrhoea and constipation – although these usually go away within a few weeks. Some people also experience discomfort in their stomach, heartburn, fatigue, dizziness, insomnia and hypoglycaemia. When compared with other weight loss treatments, however, liraglutide tends to be easier to tolerate.

The main thing to bear in mind when taking Saxenda is that you should always obtain it from a licensed clinic or pharmacy, and you should always take it as directed. You should never use more than instructed, and you should never use it without telling your prescribing doctor if you are diabetic. If you have diabetes, you will likely need a different dose to prevent your blood sugar from getting too low. 

At The Online Clinic, we can safely prescribe Saxenda to suitable patients who have completed our online questionnaire. To find out more, click here.


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