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  1. Home
  2. Medicine Safety Protocols

Treatment-specific safeguards

Medicine Safety Protocols

Some medicines need additional safety checks before supply. Our medicine safety protocols explain the checks we use for common treatment areas and why treatment may be refused, delayed or escalated.

Each consultation is assessed individually against the risks and suitability criteria relevant to that medicine.

Read our prescribing standards Contact the pharmacy team

Checks matched to the medicine

❝ Interactions, contraindications, dose suitability and red-flag symptoms are reviewed before supply. If treatment is not suitable, we may ask for more information, recommend GP review or refuse the request.❞

Abbas Kanani
Superintendent Pharmacist

Extra checks for higher-risk medicines

Interaction and contraindication screening

Dose suitability checks

Red-flag symptom escalation

Ongoing patient support

From request to decision

How our medicine safety protocols work

Each treatment area has different clinical risks. A medicine suitable for one patient may be unsuitable for another because of symptoms, medical history, current medicines, previous side effects or treatment goals.

01

Treatment requested

The patient selects a treatment area.

02

Consultation completed

Relevant health information is provided.

03

Key risks screened

Medicine-specific criteria are checked.

04

Information clarified

Further details are requested when needed.

05

Decision made

Approved, refused or escalated.

06

Advice provided

Safe-use and next-step advice is given.

Protocol 01

Weight loss treatment safety checks

Weight-loss medicines may require additional checks because they are long-term treatments, may be liable to misuse and can affect appetite, digestion, blood sugar and hydration. Suitability is assessed against BMI, medical history, current medicines and treatment history.
Check Why it matters
Height, weight and BMI To assess whether treatment criteria are met.
Weight-related health conditions Helps assess clinical suitability.
Current and previous treatment Prevents unsafe dose changes or duplication.
Current medicines Important for diabetes medicines and interaction risks.
Pregnancy or breastfeeding Weight-loss medicines may be unsuitable.
Pancreatitis or gallbladder history Relevant to GLP-1/GIP-type medicines.
Eating disorder concerns Treatment may be inappropriate or unsafe.
Gastrointestinal symptoms Severe symptoms may need review.
Dose escalation Helps prevent unsafe dose jumps.
Side effects Ongoing tolerance and safety must be assessed.

Why it matters
To assess whether treatment criteria are met.

Why it matters
Helps assess clinical suitability.

Why it matters
Prevents unsafe dose changes or duplication.

Why it matters
Important for diabetes medicines and interaction risks.

Why it matters
Weight-loss medicines may be unsuitable.

Why it matters
Relevant to GLP-1/GIP-type medicines.

Why it matters
Treatment may be inappropriate or unsafe.

Why it matters
Severe symptoms may need review.

Why it matters
Helps prevent unsafe dose jumps.

Why it matters
Ongoing tolerance and safety must be assessed.

Treatment may be refused or delayed when:

  • BMI is below relevant criteria
  • An unsafe dose has been requested
  • The patient is pregnant or breastfeeding
  • There is concern about a possible eating disorder
  • Severe abdominal pain or pancreatitis-type symptoms are reported
  • Significant side effects need review
  • Treatment history is unclear
  • There is not enough information to assess suitability

Protocol 02

Erectile dysfunction treatment safety checks

Erectile dysfunction medicines can interact dangerously with some heart medicines and may be unsuitable for patients with certain cardiovascular symptoms or conditions.
Check Why it matters
Nitrate use Can cause a dangerous fall in blood pressure.
Nicorandil Important interaction risk.
Poppers or recreational substances Can dangerously lower blood pressure.
Heart symptoms Chest pain or unstable symptoms need medical review.
Recent heart attack or stroke May make treatment unsuitable.
Blood pressure issues Low or uncontrolled blood pressure may be unsafe.
Suitability for sexual activity Some patients need medical review first.
Diabetes or cardiovascular risk ED can be a marker of underlying disease.

Why it matters
Can cause a dangerous fall in blood pressure.

Why it matters
Important interaction risk.

Why it matters
Can dangerously lower blood pressure.

Why it matters
Chest pain or unstable symptoms need medical review.

Why it matters
May make treatment unsuitable.

Why it matters
Low or uncontrolled blood pressure may be unsafe.

Why it matters
Some patients need medical review first.

Why it matters
ED can be a marker of underlying disease.

Treatment may be refused or delayed when:

  • Nitrates, nicorandil or poppers are used
  • There is unstable angina or concerning chest pain
  • A recent serious cardiovascular event is reported
  • Blood pressure is very low
  • The patient has been advised to avoid sexual activity
  • Cardiac symptoms are unclear
  • Symptoms could suggest undiagnosed diabetes or cardiovascular disease

Protocol 03

Hair loss treatment safety checks

Hair-loss medicines may not be suitable for all patients. Suitability depends on age, sex, hair-loss pattern, medical history, previous treatment and side-effect risk.
Check Why it matters
Age Some treatments are not suitable for under-18s.
Sex and pregnancy risk Finasteride is not suitable for women and has pregnancy handling warnings.
Hair-loss pattern Some patterns may suggest another cause.
Mood symptoms Relevant because mood-related side effects have been reported with finasteride.
Sexual side effects Previous or current symptoms may affect suitability.
Breast symptoms Breast tenderness or lumps need medical advice.
PSA or prostate testing Finasteride can affect PSA interpretation.
Previous treatment response Helps assess suitability and expectations.

Why it matters
Some treatments are not suitable for under-18s.

Why it matters
Finasteride is not suitable for women and has pregnancy handling warnings.

Why it matters
Some patterns may suggest another cause.

Why it matters
Relevant because mood-related side effects have been reported with finasteride.

Why it matters
Previous or current symptoms may affect suitability.

Why it matters
Breast tenderness or lumps need medical advice.

Why it matters
Finasteride can affect PSA interpretation.

Why it matters
Helps assess suitability and expectations.

Treatment may be refused or delayed when:

  • The patient is under 18
  • Symptoms are not consistent with male pattern hair loss
  • Concerning mood symptoms are reported
  • There have been previous severe side effects
  • A breast lump, nipple discharge or significant breast change is reported
  • Another cause may require GP review

Protocol 04

Herpes and sexual health treatment safety checks

Herpes treatment suitability depends on whether symptoms are typical, whether this is a first or recurrent episode, symptom severity, pregnancy status and whether testing or face-to-face assessment is needed.
Check Why it matters
First episode or recurrent outbreak First outbreaks may need testing or clinical assessment.
Location of symptoms Eye symptoms require urgent review.
Severity Severe pain, fever or urinary retention may need urgent care.
Pregnancy Requires specialist advice.
Immune suppression May need medical review.
Renal impairment Relevant for antiviral dosing.
Outbreak frequency Frequent outbreaks may need suppressive therapy or GP review.
Alternative diagnoses Symptoms may not be herpes.

Why it matters
First outbreaks may need testing or clinical assessment.

Why it matters
Eye symptoms require urgent review.

Why it matters
Severe pain, fever or urinary retention may need urgent care.

Why it matters
Requires specialist advice.

Why it matters
May need medical review.

Why it matters
Relevant for antiviral dosing.

Why it matters
Frequent outbreaks may need suppressive therapy or GP review.

Why it matters
Symptoms may not be herpes.

Treatment may be refused, delayed or escalated when:

  • This is a first severe outbreak
  • Symptoms are near the eye
  • The patient is pregnant
  • Severe pain, fever or difficulty passing urine is reported
  • The patient is immunosuppressed
  • Symptoms are not consistent with herpes
  • Outbreaks are very frequent
  • Renal impairment requires a dose review

When a concern is identified

The next step depends on the risk

We may ask further questions, refuse treatment, recommend GP review, advise a sexual health clinic, suggest NHS 111 or advise urgent medical attention depending on the symptoms.

01

More information needed

The patient is contacted before a decision is made.

02

Treatment unsuitable

The request is refused and an explanation is provided.

03

GP review needed

The patient is counselled about the appropriate next step.

04

Urgent symptoms

Urgent care, NHS 111 or emergency help is advised.

05

Suitable

The medicine is supplied with safe-use and aftercare advice.

 

Not sure whether treatment is suitable?

Our pharmacy team can help with treatment questions before or after you order.

Contact the pharmacy team How we keep patients safe
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