How We Prescribe

1. Purpose

This policy explains how SynovaMed decides whether to prescribe medication across any of our clinical services including weight loss, hair loss, erectile dysfunction, women's health, skin, sexual health, and other therapeutic areas we may introduce in future. It is written for patients as well as staff, so everyone understands our clinical approach.

2. Our Clinical Approach

All prescribing at SynovaMed follows three principles, regardless of the treatment area:

• Clinical safety first: We only prescribe where medication is clinically appropriate and safe for the individual patient.
• Evidence-based: We prescribe in line with the licensed indication, Summary of Product Characteristics (SmPC), NICE guidance where applicable, and current UK clinical evidence.
• Transparent: We explain our decisions clearly.

3. Services We Prescribe For

SynovaMed currently offers clinical prescribing across the following areas:

• Weight loss - GLP-1 receptor agonists (Wegovy / Mounjaro) for eligible adults.
• Hair loss - finasteride, minoxidil, and related topical/oral treatments.
• Erectile dysfunction - PDE5 inhibitors (e.g. sildenafil, tadalafil) and alternatives.
• Women's health - oral contraception, emergency contraception, menopause treatments, cystitis / UTI treatment, bacterial vaginosis, thrush.
• Skin - prescription skincare (e.g. tretinoin, topical antibiotics, acne treatments).
• Sexual health - STI treatment (where clinically appropriate) and prophylaxis.
• General health - other licensed prescription medicines within our formulary.

Our formulary is reviewed regularly. We only add a service or medicine when we have the clinical SOPS, prescribing competence, and supply chain in place to deliver it safely.

4. Who Reviews Your Consultation

Every consultation is reviewed by a GPhC-registered Pharmacist Independent Prescriber (PIP). Our prescribers are independent clinicians contracted by SynovaMed they are not employed in a way that creates commercial pressure on their prescribing decisions. Prescribers only take on consultations in therapeutic areas within their documented competence.

5. The Prescribing Process

Step-by-step, across every service:

• You complete our online medical questionnaire, tailored to the clinical area, covering medical history, current medications, allergies, and relevant lifestyle.
• You verify your identity using our secure ID verification service.
• A GPhC-registered PIP with competence in the relevant area reviews your consultation within 24 hours.
• If needed, the prescriber may request follow-up information (recent blood tests, GP records, photographs, or a short video call).
• If prescribing is appropriate, the prescriber issues a private prescription.
• The prescription is clinically checked by our Responsible Pharmacist before dispensing.
• Your medication is dispatched in appropriate packaging by tracked delivery (temperature-controlled for medicines that require it).

6. When We Decline to Prescribe

The specific reasons we decline vary by clinical area, and the detailed criteria for each service are in our Eligibility & Prescribing Criteria (POL-007). In general, we will not prescribe if:

• You do not meet the clinical eligibility criteria for the treatment.
• You have a contraindication listed in the medication's SmPC.
• The medication would interact dangerously with your current medicines.
• Your clinical picture suggests an underlying condition that needs investigation by your GP or a specialist first.
• We cannot verify your identity, age, or UK residency.
• Safeguarding concerns are identified during the consultation.
• You have shown signs of misuse, diversion, or obtaining medicine for another person.

If we decline, we will tell you why and signpost you to appropriate alternatives (your GP, NHS specialist services, or third-sector organisations where relevant).

7. GP Notification

We strongly encourage every patient to inform their GP about any treatment we prescribe - regardless of clinical area. Many of the medicines we supply interact with other prescriptions or need to be recorded on your summary of care. We will send a GP notification letter on your behalf if you consent.

8. Ongoing Monitoring

The frequency and type of follow-up depends on the clinical area:

• Weight loss (GLP-1s): monthly check-ins on weight, side effects, wellbeing; video review at 3 months.
• Hair loss: quarterly check-ins on progress and tolerability.
• Erectile dysfunction: review at renewal, with ad-hoc follow-up on side effects.
• Women's health (ongoing contraception, HRT): review at least annually, earlier where clinically indicated.
• Acute treatments (e.g. cystitis, STI, emergency contraception): single course with clear guidance on when to re-consult.

You can message our team at any time through the patient portal.

9. Titration and Dose Changes

Where a medication requires titration (gradual dose adjustment e.g. weight-loss GLP-1s, some HRT regimens, some antidepressants), our prescribing follows the standard manufacturer schedule. Changes to your dose are always prescriber-led and based on your tolerance and response never automatic.

10. Stopping Treatment

You can stop any treatment at any time. We advise speaking to your prescriber first so we can support you with the right approach some medications need to be tapered rather than stopped suddenly, and some conditions may recur when treatment stops.

11. Our Formulary

We only prescribe medications within our licensed, documented formulary. We do not prescribe off-label or unlicensed medicines, compounded preparations, or medicines outside our contracted prescribers' scope of competence. The formulary is reviewed and updated regularly by the Superintendent Pharmacist.

12. No Commercial Pressure on Prescribing

Our prescribers' income is not linked to the number of prescriptions they issue. There are no sales targets. Declining to prescribe is never penalised. Prescribers act solely in the patient's clinical interest. This applies equally across every service we offer.

13. Policy Review

Reviewed every 2 years, or sooner if regulatory or clinical guidance changes. Next review: April 2028.

SynovaMed (trading name of Nihaal Limited) | 11 Blaby Road, South Wigston, Wigston, LE18 4PA | GPhC: 9012552 | 07822 002914 | info@synovamed.co.uk Document Ref: POL-005 | Version 2.0 | Effective: 19 April 2026 | Next Review: April 2028 Superintendent Pharmacist: Chirag Desai (GPhC: 2079415)