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Medical History

Please answer the following questions about your medical history and current medications

  • Back pain
  • Temperature above 38°C
  • Feeling very unwell - flu like illness
  • Shivering
  • Nausea and vomiting
  • You are allergic to nitrofurantoin
  • Your kidneys do not work very well, if in doubt check first with your doctor
  • Porphyria or G6PD (glucose-6-phosphate dehydrogenase) deficiency
  • Diabetes
  • Lung disease, including asthma
  • Liver disease
  • Ongoing anaemia
  • Persistent low vitamin B, or folate
  • Antacid indigestion remedies
  • Probenecid or sulfinpyrazone (rarely used long term gout treatments)
  • Acetazolamide (glaucoma, altitude sickness)
  • Citrate or bicarbonate to neutralise urine acidity
  • Other antibiotics of the quinolone (floxacin) type
  • Oral typhoid vaccine (not usually used)
  • You will read the patient information leaflet supplied with your medication
  • You will contact us and inform your GP of your medication if you experience any side effects of treatment, if you start new medication or if your medical conditions change during treatment.
  • The treatment is solely for your own use
  • You have answered all the above questions accurately and truthfully. You understand our prescribers take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health.