Medical Assessment

Answer a few quick and easy questions from our pharmacists to see what treatments you’re eligible for.

Your Health

Are you between the ages of 18-65?

Yes No

Your answer changed, Can you share why your response changed?

Have you been diagnosed with migraine by your GP or a specialist?

Yes No

Your answer changed, Can you share why your response changed?

Have you used any of the following previously for migraines:

Sumatriptan, Naratriptan, Frovatriptan, Zolmitriptan, Almotriptan, Rizatriptan or any other ‘triptan’ medication

Rimegepant (Vydura)

I have not used any of the above previously

Please confirm whether you have an allergy or hypersensitivity to any of the following:

Rimegepant (Vydura) or any of the excipients in this medication which includes mannitol, sucralose, gelatin and mint flavour

‘Triptan’ medications (sumatriptan, naratriptan, rizatriptan, frovatriptan, almotriptan, zolmitriptan) or the other excipients in these medications

Sulfonamide antibiotics (co-trimoxazole, trimethoprim)

I am not allergic to any of the above

Are you pregnant or breastfeeding?

Yes No

Your answer changed, Can you share why your response changed?

Do your migraines follow a broadly similar pattern each time?

Yes No

Your answer changed, Can you share why your response changed?

Do you experience migraines more than 10 days a month?

Yes No

Your answer changed, Can you share why your response changed?

Do your migraines last less than 4 hours without treatment?

Yes No

Your answer changed, Can you share why your response changed?

Do you have any of the following symptoms:

Double vision
Tinnitus (ringing in the ears)
Loss of consciousness
Seizures/fits
Balance related issues
Weakness on one side of body linked to the migraine
A recent rash with a headache
Migraine that has lasted more than 24 hours despite use of medication
Migraine that has lasted longer than 72 hours
Headaches that are made worse when pressure applied for example when coughing or sneezing
Confusion
Chest pains and/or breathing difficulties
Blood in urine
Pounding sensation and/ or irregular heartbeat
Neck stiffness and discomfort
Increased severity, frequency or duration of migraine attacks since your last review with your GP

Yes No

Your answer changed, Can you share why your response changed?

Medical Conditions

Do you have any other medical conditions?

Yes No

Your answer changed, Can you share why your response changed?

Do you have any of the following conditions:

Liver problems
Kidney problems
History of myocardial infarction (heart attack) or stroke
History of gastrointestinal or splenic infarction
Other heart conditions such as angina, ischaemic heart disease, coronary vasospasm (angina), peripheral vascular disease and symptoms or signs consistent with ischaemic heart disease
History of cerebrovascular accident (CVA), or transient ischaemic attack (TIA)
Hypertension (High blood pressure)
Hemiplegic, basilar, or ophthalmoplegic migraine
Diabetes
Epilepsy or a history of seizures
Stomach or duodenal ulcers
Ischaemic colitis
Galactose intolerance, fructose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption

Yes No

Your answer changed, Can you share why your response changed?

Medication

Do you take any other medication?

Yes No

Your answer changed, Can you share why your response changed?

Do you take any of the following medications?

Ergotamine, or derivatives of ergotamine (including methysergide)
5-HT1 receptor agonists/triptans such as rizatriptan and zolmitriptan
Monoamine oxidase inhibitors (MAOIs) to treat depression, either currently or within the last 2 weeks, such as moclobemide, phenelzine, tranylcypromine, selegeline
Selective serotonin reuptake inhibitors (SSRI’s) such as fluoxetine, paroxetine, etc.
Selective norephrine reuptake inhibitors (SNRI’s) such as venlafaxine, duloxetine, etc
Reboxetine, tryptophan or flupentixol
Lithium
Propranolol
Combined oral contraceptive pill
St John’s wort
Cimetidine
Any current course of antibiotics
Anti-fungal medication such as ketoconazole, fluconazole, itraconazole
Medicines that control heart rhythm (amiodarone, quinidine, verapamil, diltiazem etc)
Medications for epilepsy
Medications for HIV
Medications for cancer
Bosentan
Rifampicin
Modafinil
Ciclosporin
Medications for angioedema (betrolastat)
Regular preventative medication for migraine such as propranolol, topiramate, amitriptyline and pizotifen
Medications for cystic fibrosis (ivacaftor)

Yes No

Your answer changed, Can you share why your response changed?

Agreement

Do you understand that Vydura can be used in two ways; either as a treatment for migraine attacks as and when they happen, or for prevention of migraine attacks. The dosage for treatment is one 75mg tablet when required (maximum one a day) and the dosage for prevention is one 75mg tablet every other day. Vydura should not be used for prevention of migraines if you are having less than 4 migraine attacks a month.

Yes No

Do you understand that you should seek urgent medical help if:

You experience paralysis or weakness on one or both sides of the body
You experience slurred speech or difficulty speaking
You have a headache that’s sudden and severe - worse than any other headache you’ve had
Your headaches are accompanied by a high temperature, stiff neck, confusion, seizures, vision problems and a rash

Yes No

Do you agree to the following:

You will read the patient information leaflet before using this medication
You are aged 18 years or over
You have answered all questions truthfully and accurately
If you have an NHS Summary Care digital record, our specialists can check it to ensure this medication is safe for you
You understand that we take your answers in good faith and any false or incorrect information given can be hazardous to your health
This treatment is solely for your own use
You will inform your GP that you have been prescribed this medication if this is appropriate
You will contact us and inform your GP if you experience any side effects with your treatment, you start any new medication/your medical conditions change during treatment
You are capable of making your own decision about your healthcare and have the capacity to do so

Yes No

GP Details

We can notify your GP of your treatment for you. To do so, we need their contact information. Sharing this information allows your GP to maintain a comprehensive record of your medical history, which is crucial for your health. Without complete records, there could be potential risks to your well-being.

I consent to YourMedicals contacting my GP and share information about my prescription.

Yes No

Practice/GP Name

Practice/GP Address

Verify your BMI

To comply with regulations and ensure the safe provision of weight loss treatment, we need to verify your BMI. You may complete this step later, but we cannot proceed with your prescription until it is provided.

Upload Now Upload Later

Upload Your ID

Please upload a government-issued photo ID that meets the following criteria:

Clearly shows your face, name, and date of birth.
Ensure the image is free from reflections and blurriness.
All four sides of the ID must be visible.

Why We Request a Photo ID

We prioritise your safety and ensure compliance with medical regulations. Our prescribing team requires a government-issued photo ID to:

Verify your identity.
Ensure that all information you have provided matches the details on your ID.

Your information is handled with the utmost confidentiality and security

Upload ID

You have chosen to upload your documents at a later time. A confirmation email will be sent to you shortly with instructions for uploading.

Please note, your order will be placed on hold until the required documents are uploaded. Once the documents are provided, we will proceed with processing your order.

Complete our 2 minute questionnaire

Confidential

Our prescribers will carefully review your information with full confidentiality.
Your medication will be delivered in plain, unmarked packaging
All data is securely encrypted using 128-bit SSL encryption.

Need help?

Quantity

£42.99

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