Wednesday, 17 August 2016

Bring Back Happy Memories and a Tan from a Summer Holiday – Not an STI

Summer is in full swing, the kids are off school, and that happy, glorious mood is in the air. One that is simply lacking in the cold months of winter.

Summertime also usually means thousands of Brits will be flocking overseas to even hotter climates in order to soak up the sunshine and enjoy a party atmosphere, usually fuelled by booze. Sunshine and booze abroad sounds idyllic, however it can lead to some risky behaviour when it comes to sex.

Holidays can provide the chance to meet new people, or get much closer to somebody you already know, but remember that it is absolutely vital to still think about sexual health when on holiday. After all, unprotected sex on holiday can have the same catastrophic consequences that it can have at home, namely sexually transmitted infections (STI) and unwanted pregnancies.

Protecting one’s own sexual health, and that of any potential sexual partner whilst on holiday, is imperative. Don’t forget to pack condoms as STIs aren’t the only reason to use condoms. Sickness and diarrhoea, in addition to certain medicines like anti-malaria tablets, may make the contraceptive pill less effective.

It is understandable that a visit to the local pharmacy perhaps isn’t the first thing on people’s minds when arriving to a holiday destination. Moreover, depending on the destination in question, it could be next to impossible to even find a trustworthy supply of genuine condoms.

Therefore, prior to any holiday, have a think about what you realistically may or may not get up to as it would possibly be wise to stock up on good quality condoms and important essentials with regards to sex. Some destinations have much higher rates of sexual infections compared to others, meaning the use of contraception is an even bigger must.

In particularly, the rates of certain serious sexually transmitted infections such as HIV and syphilis are significantly higher in some countries around the world in comparison to the UK. In fact, the majority of new HIV cases diagnosed amongst heterosexuals were caught overseas.

Unfortunately, it’s not usually possible to know if somebody has an STI or HIV simply by looking at said person, so for this reason alone, always wear a condom!

Those who forget to pack condoms for their jollies, should only purchase condoms bearing the European CE mark as this is a sign of quality assurance. This means the condoms have been tested to the required safety standards.

Exposure to the sun can actually damage the condoms, so it is vital to keep them stored in a cool and dry place. Also, don’t leave them packed closely together with any sun cream, baby lotion, or other oily products that can cause damage. It is also essential to wash hands between rubbing on the sun lotion and handling a condom.

At Medical Specialists® Pharmacy we realise that maybe only a small percentage of holidaymakers will be sensible enough to always use condoms when engaging in sexual activities. Anyone that has been careless and engaged in unprotected sex will be putting themselves at risk of infection.

Most that do end up displaying STI symptoms will not experience them until about two weeks after returning from holiday. Worryingly, with one of the most prevalent STIs – chlamydia – most infected people will be oblivious to actually having it due to no obvious symptoms. Approximately 50% of men and 70 to 80% of women will not experience any symptoms at all with the infection.
Symptoms of STIs can include:

. A pain or burning feeling when urinating.
. For women, bleeding between periods and/or after sex.
. Itching, blisters, sores or lumps on or around the genitals.
. Pain when urinating.
. Unusual discharge from your penis, vagina or anus.

Medical Specialists® Pharmacy provide treatments for many of the more common STIs such as chlamydia, gonorrhoea and genital herpes.

In addition, Medical Specialists® can provide almost 100% accurate pregnancy tests to be used in the privacy and comfort of a woman’s own home, a wide variety of condoms to suit different preferences, emergency hormonal contraception (morning after pill), other contraceptive pills, and the previously mentioned chlamydia test to be taken at home and posted off for a quick analysis and result, avoiding the time and embarrassment of having to personally attend a clinic for a check-up.

To obtain any prescription or antibiotic or contraceptive treatment, all patients must first undergo an online consultation with one of the GMC-registered doctors at Medical Specialists®, or send in a private prescription by post, obtained from the patient’s own doctor.

Traffic pollution and cleaner homes mean HALF of us could have allergies by 2026

Within just a decade there could be up to half of the UK population suffering from hayfever, asthma, or another type of allergy, health experts are warning. The problems are mainly linked to an increasing amount of traffic pollution and much cleaner homes.

If current trends carry on at their current pace, millions more people will be reaching for their antihistamine or being prescribed asthma inhalers by the year 2026 to combat symptoms such as runny nose, watery and itchy eyes, sneezing (hayfever), and breathlessness (asthma).

Currently, around 1 in 4 people have at least 1 kind of allergy, with the number of people suffering going up by an additional 5% per year.

An estimated half of all sufferers are children. By 2025 asthma alone will likely become the most prevalent chronic childhood condition and have one of the largest healthcare costs.

A cleaner environment at home with less childhood infections, increasing traffic pollution and multiple types of pollen have been highlighted as factors behind the allergy rise.

Allergies of all kinds have soared in recent years. For example, in the last decade alone, cases of food allergies have doubled in number.

With regards to the most severe form of allergic reaction – anaphylaxis – there has been a massive 615% jump in hospital admissions between 1992 and 2012.

Sheena Cruickshank, senior lecturer in immunology at Manchester University, told the ESOF science forum: “Allergy is really common and it’s thought to be increasing.

“It’s not something we saw a hundred years ago and maybe in ten years’ time 50 per cent of us are going to be suffering from hay-fever, asthma, or food allergy.

“Basically we are looking at that kind of trend year on year. We are certainly seeing more young people affected by an allergy and we do see adults develop it in later life.

“Why is this happening? There are lots of theories, such as the fact we are very clean now so our immune system doesn’t get properly educated.

“Or the types of infection we get exposed to are very different, and again makes our immune system misfire.

“But of course the other thing is our atmosphere has very much changed.

“We are farming different crops and on a different scale so there are different pollens, and more of them. And there are the invisible pollutants we are exposed to.”

A new project known as Breathing Britain is attempting to determine the causes behind respiratory allergies by the use of a mobile phone app.

The app will pinpoint a person’s location, whilst analysing their symptoms, as well as pollen and pollution levels – particularly whilst at the time of an allergic attack.

Dr Cruickshank added: “The real issue in trying to understand the cause-and-effect is the lack of good quality data.

“If you think about the average person with hay-fever, the only time they will go a doctor or a hospital is when they are very unwell.

“We have no data whatsoever on the day-to-day symptoms people are living with. We don’t know when the symptoms are starting and when they are starting to have difficulties.

“The only way to get data is to work with the public, and that’s what we’ve been doing.”

Professor Gordon McFiggans, an atmospheric researcher, said: “Our work is all about finding the level of data needed to make good policy decisions.

“If we are going to tackle the issue of pollution, we need more integration between policy makers and scientists.

“And measurements of atmospheric pollutants on the ground and measurements of their impact on health is a hugely important part of that mix.”

Viagra for a stiff back? Scientists say ED drug could treat sciatica

We all know erectile dysfunction drug Viagra has been helping men get ‘stiff’ in the bedroom for almost 20 years now, but could it prove to be a potent remedy in the fight against stiff backs?

This could indeed be the case after Turkish researchers looked into the potential of Viagra – also known as ‘the little blue pill’ – being utilised as a treatment for sciatica.

Tests involving rats seemed to demonstrate that the wonder male impotence drug manages to alleviate the painful symptoms associated with sciatica, a painful condition which affects a million UK men and 400,000 women.

Researchers involved in the tests made the discovery that a daily dose of the erectile dysfunction treatment can quicken recovery. Taking Viagra for a month also managed to heal damaged nerves and helped increase movement.

Exercise, acupuncture, and an anti-inflammatory painkiller such as naproxen or diclofenac are the usually the first port of call for treating sciatica, but in more serious scenarios – such as if the pain has lasted more than 6 weeks, the patient could need surgery to stop the pain from reoccurring.

However, scientists based in Malatya, eastern Turkey, found anti-impotence medication Viagra to be successful at offering pain relief during tests on 30 rats.

The scientists administered a daily dose of Viagra to some of the rats they tested, and others were given a smaller amount every other day, whilst some rats received none of the drug at all.

Remarkably, the rats given the daily dose of Viagra actually ended up being able to enjoy more movement in comparison to those in the other groups.

Scans were conducted on the rats, finding they had higher levels of nerve regeneration, meaning that Viagra had accelerated the body’s healing mechanisms.

The drug would appear to work by boosting the blood supply to damaged areas. Scientists commented in a report: “We believe a daily dose of Viagra plays an important role in treatment of sciatic nerve damage.”

Sciatica is the term used for when pain caused by irritation or compression of the sciatic nerve. If the sciatic nerve becomes compressed or irritated, it usually results in pain, numbness and a tingling sensation emanating from the lower back and travelling down one of your legs to your foot and toes.
Many pregnant women incorrectly believe they have sciatica – in fact they are more likely to be suffering with pelvic girdle pain (PGP), which is much more common and has some of the same symptoms as sciatica.

While people with sciatica may suffer with general back pain, the pain caused by the condition is primarily located in the buttocks and legs much more than the back.

Depending on how the condition is defined, an estimated 2% to 40% of people will suffer with sciatica at some point in their life. It is more predominant in people aged in their 40s and 50s, and perhaps surprisingly to some, it is actually men who are often more affected than women.

Smokers trying to quit could end up boozing less as well

Those trying to quit smoking for the countless health benefits will be delighted to hear there could be an additional booster from ditching the cigarettes – you may also end up giving up drinking too!

This is according to the findings from a new study, conducted at University College London, where researchers realised that previous studies already identified links between smoking and drink. After all, how many of us have seen someone gulping down a pint whilst simultaneously having a cigarette lit and ready to smoke.

For the new study, published in the journal BMC Public Health, researchers conducted household surveys, finding that 6,287 out of 31,878 people reported smoking between the period of March 2014 and September 2015.

Of these, it was discovered 144 smokers had made an attempt to stop smoking in the week leading up to the survey. Moreover, they had completed a validated questionnaire known as the Alcohol Use Disorders Identification Test.

Researchers classified the smokers as light or heavy drinkers – and analysed their current attempt to cut down on alcohol.

They then looked at their recent attempt to stop smoking, finding that the ex-smokers generally drank less alcohol within the first week of ditching cigarettes, and they were also less inclined to binge drink.

In addition, they were found to be more likely to be ‘light drinkers’ – staying inside the governmental drinking guidelines, in comparison to the smokers who were not trying to stop smoking.

Lead author Jamie Brown, from University College London, England, said: “This study found that smokers who reported attempting to stop within the last week had lower levels of alcohol consumption, especially binging.”

He added, “These results go against the commonly held view that people who stop smoking tend to drink more to compensate.

“It’s possible that they are heeding advice to try to avoid alcohol because of its link to relapse.”
The study also took into account what accessible literature there was on regarding the relationship between smoking and alcohol consumption.

Drinking alcohol is often thought to be a sign of a lapse – seeing newly-quit smokers going back to their old habits. For this reason, smokers are often told to reduce alcohol intake whilst trying to quit.
Dr Brown noted that this was an observational study and is unable to say for certain if stopping smoking can cause a decrease in drinking or vice versa. He did say that smokers could choose to ditch that extra glass of wine or pint of beer during their attempt to quit smoking, as a booster to their chances of being successful.

On the other hand, it could be the case that those who drink less are simply more likely to quit smoking.

Therefore, smokers that are also heavy drinkers will need more forms of encouragement to stub out in comparison to other groups. In addition to money spent on trying to get people to stop smoking, future health campaigns could also target people trying to quit smoking in order to reduce their drinking.

Too many fizzy drinks found to be bad for the penis

Fizzy drinks have perhaps rightfully received plenty of bad press in recent years on a regular basis. After all, the high sugary drinks have been closely linked to tooth decay, weight gain, diabetes, heart disease, cancer, and can even quicken up the aging process.

Now there could be another reason to leave the fizzy drinks well alone, with scientists reporting there is a link between soda consumption and problems ‘down there’ for men – more specifically fertility and erectile dysfunction.

Scientists based at Copenhagen University Hospital made the findings after looking at consumption of Coca-Cola. For the study they looked at 2,554 men who drank large amounts of coke and found that drinking 1 litre of the fizzy drink on a daily basis could cut a man’s sperm count by a staggering 30% and also cause impotence problems.

Those addicted to fizzy drinks were found to have an average sperm count of 35 million per millilitre, compared to 56 million per millilitre in those who consumed less coke. Despite 35million per millilitre falling within the normal range, it will place men more at risk of eventually becoming infertile.

Even though many would probably assume caffeine to be the culprit for the men’s health risks, researchers in the study discovered there does not seem to be any direct correlation between the caffeine consumed in other drinks such as coffee and tea, meaning there is something else within fizzy drinks that is the root of the problems.

The scientists did note that while getting an erection also depended on both physical and psychological factors, they believe that there is a sweetener used in the drink which could cause damage to arteries in the penis, hindering the blood flow through it.

The failure of being able to achieve and sustain an erection may in fact be a result of large amounts of fructose corn syrup, a sweetener added to many fizzy drinks. In addition, visceral fat deposition, caused by unhealthy diet habits such as drinking fizzy drinks, is also a factor in erectile dysfunction.
In conclusion, the scientists report that drinking the odd can of coke or other fizzy drink should be OK and not lead to any catastrophic side effects, but those guzzling more than a litre per day should try and cut down.

Going to the Rio Olympics? Read on for advice on 6 Health Risks

With their inflated salaries, multi-million pound sponsorship deals, mansions and flash cars, sometimes it is easy to forget that celebrities are human beings just like the rest of us. Money worries aside, they generally share the same concerns as everybody else and are not invincible superhuman characters that are immune to ill-health.

This was epitomised recently with the golfer Rory McIroy’s withdrawal from the 2016 Summer Olympics, taking place in Rio de Janeiro. Mcilroy sacrificed taking part in what will be the first golfing event to be played at the Olympics since the 1904 Summer Olympics, after being concerned about the outbreak of Zika virus.

This isn’t the first time a major sporting event has been held in the country in recent years, with the 2014 World Cup taking place there resulting in the entire England football team being prescribed antimalarial malarone to fend off malaria.

With all this in mind, clearly there are some health concerns not only in Rio, but other areas around Brazil, which both spectators and the sportsmen and women themselves need to consider when travelling over to the South American country.


Malaria is a high risk disease in many parts of Brazil, making a resurgence in the forested areas of Rio de Janeiro State during early 2015. However, authorities reported that local transmission had stopped by mid-2015.

The potentially deadly mosquito-borne virus is actually at very minimal risk in Rio, and as such, International authorities do not usually recommend antimalarial medication for the area.
The NHS fit for travel Brazil malaria map gives a guide of which areas of the country are typically a high risk for the disease.

Those wishing the venture further out from Rio are advised to discuss this with their GP as malaria precautions are essential, and you cannot be vaccinated against it. Malarone or doxycycline or mefloquine is usually recommended for those visiting risk areas. If malaria tablets are prescribed for any given trip, it is important to continue once out of the risk area as directed.

In addition, people can do their best to avoid mosquito bites by covering up with clothing such as long sleeves and long trousers – especially after sunset, using insect repellent that contains DEET (N, N-diethyl-meta-toluamide) on exposed skin after sunscreen has been applied – such as Jungle Formula, and, when necessary, sleeping under a mosquito net.

Sexually transmitted infection

Individual sex work is legal in Brazil, and many travelling tourists may wish to take advantage of this. As such, Brazil’s one million sex workers will be looking to cash in on the influx of extra potential customers during the Rio Olympics.

However, it is worth remembering that Brazil is one of numerous countries in South America with high rates of sexually transmitted infection and HIV, although recent intervention from the Brazilian government has led to condom distribution increasing more than 45% between 2010 and 2011 (from 333 million to 493 million condoms).

Holidays may be viewed as a time to have fun, but it shouldn’t be at the expense of health. Medical Specialists® Pharmacy advise all UK travellers to pack good quality UK-manufactured latex condoms and use one each and every time sexual activity takes place.

It is also worth remembering that some are arguing that Zika virus should be treated as a sexually transmitted infection and urging the Brazilian government to do more to emphasise the practice of 4safe sex as a form of prevention.
Zika virus

Zika virus has been consistently in the news through 2016 and is an illness transmitted by mosquitoes. Around 80% of those infected with Zika won’t experience any symptoms, but those who do will experience symptoms such as mild fever, rash, conjunctivitis, muscle and joint pain and fatigue.

Zika poses a huge risk to pregnant women, mainly due to the fact evidence suggests it causes birth defects – in particular, abnormally small heads (microcephaly).

As such, those pregnant or planning to become pregnant are strongly advised to seek pre-travel advice from a health care provider 6-8 weeks in advance of travel. It is recommended that pregnant women postpone non-essential travel to Zika affected countries.

Apply DEET-containing insect repellent during the day and wear loose fitting clothing as mosquitoes can strike at any time in the day. Moreover, couples should use condoms whilst at the Olympics and for 8 weeks upon returning home.

Anyone who experiences Zika symptoms in Brazil, seek medical advice at the earliest opportunity. There is no specific treatment or vaccine for the Zika virus and those who feel unwell you should rest, drink plenty of fluids and take paracetamol to treat fever or pain.

Dengue fever

Dengue fever is a huge problem in Brazil. In fact, in 2013 there were a record 1.4 million suspected dengue fever cases reported in the country.
Travellers should take precautions to avoid mosquito bites due to the fact there is no vaccine to protect against the dengue fever virus. Using insect repellent and sleeping under a mosquito net are two ways to help protect yourself.


Although rabies can be found in dogs, bats, and other mammals in Brazil, it is not considered to be major risk to most travellers. Rabies is transmitted through the saliva of an infected animal, commonly through a bite, scratch or lick on broken skin, and Brazil is deemed to be a ‘hisk risk’ country for rabies in animals by the World Health Organization.

It may just suffice to increase awareness of the rabies risk, avoid contact with animals (including bats), as well as report any bites for assessment.

However, those planning to stay in Brazil after the Olympics have finished, in order to travel to more remote and rural areas – i.e. for caving trips where immediate access to treatment is unavailable – may be advised to see their GP for a rabies vaccine, 4-6 weeks before travel.

Yellow fever

Similar to malaria and dengue fever, yellow fever is transmitted through mosquito bites. However, the disease is preventable by a vaccination, especially recommended to those who are visiting the highly popular tourist destination Igazu Falls.

With regards to low-risk yellow fever areas, travellers are still advised to apply a DEET-containing insect repellent to exposed skin and consider other mosquito-bite prevention methods, for both indoors and outdoors.

Just a single dose of the yellow fever vaccine offers protection against the disease for around 10 years, but must be administered at least ten days before a trip. Moreover, many countries require a yellow fever vaccination certificate before entry, although exemption certificates can be provided for people unable to have the vaccination on medical grounds.

Branded drugs up to EIGHT times pricier than generic versions

Martin Lewis may have sold off most of his shares in, however the multi-millionaire obviously still cares about saving the general public a few quid.

Lewis, the founder of the hugely popular price comparison website, has spoken out about the pharmaceutical industry – in particularly the topic of branded drugs v their generic equivalents. He and his team conducted research into the matter and made some alarming discoveries.

The researchers looked at the retail price of 15 over-the-counter medications and found how the branded versions are on average almost thrice as expensive as non-branded ‘generic’ drugs. To put it into context, Loratadine 10mg x 30 tablets is priced at £1.99 from Medical Specialists® Pharmacy, whereas the similar Boots One-a-Day Allergy Relief 10mg x 30 tablets costs £8.19.

Painkiller brand Nurofen was found to be most over-priced branded medicine, costing at around 8 times the price of a generic, non-branded equivalent, followed by Clarityn (a branded version of Loratadine), and then Anadin Paracetamol.

However, according to the article in the Daily Mail, pharmacies such as Boots and Lloyds are selling ‘own-brand’ generics at over 3 times the price of the lowest priced generic version – sometimes even costing more than the branded equivalents.

Consumers may benefit from an 87% saving by switching from a Nurofen (16 pack) priced at £1.98 and opting for Asda’s own brand, costing just 25p. Moreover, there is an 83% saving to be made by swapping antihistamine Clarityn (30 pack) for a £1 equivalent sold at Savers.

The research comes after the Advertising Standards Authority (ASA) recently banned a TV advert by Nurofen for falsely claiming the Nurofen Joint & Back Pain Relief tablets could specifically target joint and back pain. The ASA found ‘there was no mechanism by which the product actively sought out the source of pain’.

Martin Lewis, founder of, said: ‘The pharmaceutical industry is full of genuine wizards. There are the ones who make the drugs that help in the first place.
“Then there are the marketers who use a raft of tricks to persuade us there’s hidden magic to their branded goods.

“Actually what really counts is the active ingredient. That’s the stuff that does the job. If it’s the same, sticking with branded drugs doesn’t give extra aid to your health, it just hurts your wealth – with massive mark-ups that go to pay for their adverts and profits.

He continued: “These household name firms also sell virtually identical products in different packaging, to make you think you’ve got a targeted special medicine for your condition – in fact it’s just the same old thing.

“Yet the marketing creates a little doubt – we’re all guilty of thinking “surely there must be a reason for saying this one is good for back pain” – and when you’re hurting you spend a little extra.
“Don’t think Boots and Lloyds Pharmacies are any better either. Some of their “own brands” especially for hay fever are far more costly than the generic tablets they also sell – and again it’s the same active ingredient.

“Only those with allergies need to take care, as then you also need to check there’s nothing in the ‘non-active’ ingredients that’s different too.”

For the research, Lewis and his researchers analysed the cheapest prices they could gather for popular over-the-counter drugs, looking at in-store and online where possible, at Asda, Boots, Home Bargains, Lloyds, Poundstretcher, Sainsbury’s, Savers, Superdrug and Tesco. Independent and internet pharmacies were excluded from the research.

The research showed that generic versions beat branded the medicines on price and have the same active pharmaceutical ingredient, but found there are other ingredients which can vary.
Lewis added: “Make sure you’re aware of any possible allergic reactions and ensure the medication you choose if correct for you – if in doubt, check with the pharmacist or your GP.

“It is also worth noting that the flavours and taste of generic medication can differ to branded products too.”

He also stressed that companies can market various products differently, even those with the same active ingredient in, which could confuse consumers.

Although the MHRA allow non-prescription drugs to have ‘informative’ names to help people find a product without any assistance, Lewis and his team came to the conclusion that this is resulting in very similar medicines being marketed in different ways.

For example, they found 8 Nurofen products, all of which had Ibuprofen as their active ingredient.

Ranking based on saving as a % ranked largest to smallest
Branded product
Cheapest price
Generic equivalent
Cheapest price
Saving as a percentage
1 Nurofen (16) £1.98 Asda Ibuprofen (16) 25p Asda 87%
2 Clarityn (30) £6 Sainsbury’s (i) Loratadine (30) £1 Savers 83%
3 Anadin Paracetamol (16) £1 Savers Paracetamol (16) 19p Asda 81%
4 Nurofen Joint and Back Pain Gel 35g £4 Asda Ibuprofen gel 35g 99p Home Bargains 75%
5 Piriteze (30) £6 Sainsbury’s (i) Cetirizine (30) £1.49 Poundstretcher 75%
6 Sudafed Blocked Nose capsules(12) £2.39 Lloyds Max Strength Congestion Relief 60p Sainsbury’s 75%
7 Anadin Extra (16) £1.99 Lloyds Aspirin Extra 54p Asda 73%
8 Imodium Original (6) £2.19 Savers Loperamide (6) 59p Home Bargains 73%
9 Nurofen Kids 100ml £3.15 Sainsbury’s Ibuprofen 3+mths 95p Savers 70%
10 Vicks Sinex Micromist 15ml £3 Asda Nasal Decongestant Spray 15ml £1 Asda/Tesco 67%
11 Calpol Infant 2+ mths 100ml £2.98 Asda Infant Paracetamol Suspension 100ml £1.09 Home Bargains 63%
12 Corsodyl 300ml £4.49 Superdrug Chlorhexidine 300ml £2 Sainsbury’s 55%
13 Nurofen Migraine (12) £2.65 Sainsbury’s Migraine Relief (12) £1.35 Asda 49%
14 Lemsip Max sachets (10) £2.69 Savers Max Strength Cold and Flu £1.76 Asda 35%
15 Piriton (30) £3 Sainsbury’s Chlorphenamine Maleate (30) £2.75 Tesco 8%
(i) Usually £9

Generic V Own Brand Medicines
Active ingredient Asda
Cheapest brand
Cheapest generic
Cetirizine (30) £2.50 £8.19 £7.79 £2.75 £2.75 £6 (ii) £1.49
Max Strength Cold & Flu (i) £1.76 £2.99 £2.79 £2 £1.80 £2.69 £1.76
Loperamide (6) £1 £1.99 n/a £1 £1 £2.19 59p
Loratadine (30) £2.50 £8.19 £7.99 n/a £2.75 £6 (ii) £1
Paracetamol Suspension £1.75 £2.65 £2.29 £1.90 £2 £2.98 £1.09
(i) Paracetamol 1000mg, phenylephrine hydrochloride 12.2mg (ii) Usually £9