About your condition and treatment
To help us understand that this treatment is the right option for you, please answer the following questions. If you get stuck or need any help, you can contact us.
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Do you have any allergies?
If yes, please provide details
Have you ever had an allergic or anaphylactic reaction to naproxen, aspirin, ibuprofen or any other medication?
If yes, please provide details
Women only: Are you pregnant, planning pregnancy, or is there any possibility that you could be pregnant?
Women only: are you currently breast-feeding?
Do you have any problems with your stomach or gut (intestine), such as an ulcer or bleeding?
Do you have high blood pressure, diabetes, high cholesterol or are you a smoker?
If yes, please provide details
Did you start experiencing period pain more than a year after after starting menstruation?
Do you have any symptoms?
If yes, please provide details
Do you have any autoimmune condition such as systemic lupus erythematosus?
Do you have any recent or past medical history of note?
If yes, please provide details
Do you have any liver problems?
If yes, please provide details
Do you have any kidney problems?
If yes, please provide details
Have you been told by your doctor you have an intolerance to any sugars (e.g galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption)?
If yes, please provide details
Do you have any heart problems?
If yes, please provide details
Do you have difficulties conceiving or are you undergoing investigation of fertility?
Do you have a bleeding disorder, including taking any medication that thins your blood (anticoagulants)?
Do you have a history of gastrointestinal diseases such as ulcerative colitis or Crohn's disease?
Do you have asthma, allergies (like hay fever), polyps or rhinitis?
Do you have any other recent or past medical history of note?
If yes, please provide details
Please list all your current prescription medication including any medication you buy over the counter...
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