Consultation

Does the current infection affect just one ear?

Are you breast feeding?

Have you had a serious reaction or intolerable side
effects to neomycin sulfate, dexamethasone, glacial
acetic acid or any medications before?

Do you have a perforated ear drum or grommet fitted in the affected
ear?

Are you pregnant, planning pregnancy, or is there any
possibility that you could be pregnant?

Are you immunosuppressed due to disease or treatment?

If you pull the the middle of your earlobe towards the back of your head does this worsen the pain?

Are you using Otomize to treat a recurrence of an infection that was previously diagnosed as swimmer’s ear?

Have you ever suffered from the  below:

• Chronic ear infections
• Fungal ear infections
• Ear wax that requires treatment

Do you have an infection anywhere other than in
the ear?

Do you have any open wounds or damaged skin in the affected ear?

Have you experienced a considerable amount of
discharge from your ear or swelling of the ear
canal?

Do any of the following apply to you:

• You have cholesteatoma (an abnormal growth of skin in the middle ear behind the eardrum) either from birth or due to chronic ear infections
• You have had problems with your ears in the past which have required you to see an ear, nose, and throat specialist (ENT doctor).
• You have discomfort in the jaw when chewing or speaking
• You have facial nerve palsy (drooping face on the side of the lesion)
• You have a temperature over 39°C
• You feel physically unwell
• You have extensive hearing loss
• You are suffering from vertigo
• You have an infection spreading beyond the ear
• You have extensive discharge from the ear

Do you agree to the following? 

• 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 are over the age of 18 and you have entered your own information for our identity verification checks
• You have answered all the above questions accurately and truthfully
• You understand our doctors take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health
• You will inform your own GP of this purchase if appropriate
• You have read our privacy policy, cookie policy, patient agreement, data sharing agreement and Terms & Conditions

What is the name of your GP surgery and do you consent to us contacting them about your treatment?

Do you consent to us accessing your GP records? This is advised so we can clinically assess suitability.