Author name: Murrayfield Pharmacy

Choosing malaria tablets is not simply a matter of picking a medicine before you fly. The right advice depends on where you are going, what you will be doing and your own health. A tablet that is appropriate for one itinerary may be unnecessary, unsuitable or less effective for another. A travel health consultation can help you assess the risk and plan protection that fits your trip. Malaria risk depends on your itinerary Malaria is found in some parts of the world, but risk can differ considerably within a single country. It may vary between cities and rural areas, between regions, and according to the time of year. Your route, length of stay, accommodation and activities all matter. For example, a trip that includes remote or rural areas may need different advice from a short stay in a major city. It is important to discuss your full itinerary, including stopovers and any side trips you are considering. A travel clinician will use current destination guidance to assess whether malaria tablets are recommended and which option may be suitable. Advice can change, so do not rely only on what a friend took, or on guidance given for a previous visit. Even if tablets are recommended, they are only one part of prevention. Mosquitoes that spread malaria can bite from dusk to dawn, so reducing bites remains important throughout your stay. Why your health matters when choosing tablets Several medicines can be used to prevent malaria, but they are not interchangeable for everyone or every destination. The choice may depend on your age, weight, medical history, allergies, pregnancy or breastfeeding, and any medicines or supplements you take. Your clinician can check these factors alongside destination guidance. Pregnancy and breastfeeding: malaria can be particularly serious during pregnancy. If you are pregnant, planning a pregnancy or breastfeeding, ask for individual advice before travel. In some circumstances, postponing travel or changing the itinerary may be the safest option. Existing conditions: kidney problems, a history of seizures, certain mental health conditions and heart conditions may affect which medicine is suitable. The relevance depends on the specific medicine and your circumstances. Other medicines: some treatments can interact with antimalarials or affect how well they work. Bring an up-to-date list of your prescribed medicines, over-the-counter products and supplements to your appointment. Previous side effects or allergies: tell the clinician about any past reaction to malaria tablets or antibiotics. This may help identify a more suitable option. Children: children need advice based on their age and weight, and some medicines are not suitable for younger children. Do not share tablets or adjust an adult dose yourself. These details do not automatically rule out a particular medicine. They help a clinician weigh up the options safely and explain any precautions that apply to you. Taking malaria tablets correctly The timing depends on the medicine. Some tablets need to be started before you enter a malaria-risk area, while others must be continued for a period after you leave. Starting late, missing doses or stopping too soon can leave you less protected. Follow the instructions given for your specific medicine, and ask for clarification if the schedule is unclear. Plan ahead where possible. A consultation several weeks before departure gives time to review your health, arrange any recommended vaccines and begin tablets at the appropriate point. If your trip is soon, still seek advice: a clinician can explain what options remain and how to reduce your risk. If you develop troublesome side effects, contact a healthcare professional for advice rather than stopping or changing your tablets without guidance. If you vomit soon after taking a dose, or have severe diarrhoea, ask what to do, as your protection may be affected. Keep your tablets in their original packaging and take enough for the full course, plus a small allowance in case your return is delayed. Preventing mosquito bites as well No malaria tablet offers complete protection, so combine it with measures to avoid bites. Use an effective insect repellent according to its label, cover exposed skin with long sleeves and trousers, and choose accommodation with well-fitting screens or air conditioning where possible. Use an insecticide-treated mosquito net if recommended for your destination or sleeping arrangements. Remember that bite prevention is also useful against other mosquito-borne infections for which malaria tablets provide no protection. Ask about the right repellent and other precautions for your destination as part of your travel health planning. Know what to do after your trip Malaria symptoms can begin after you return home, sometimes weeks or months after travel. Fever is a key warning sign, but symptoms can also include chills, headache, muscle aches, tiredness, nausea or vomiting. These symptoms can resemble common illnesses, so tell the healthcare professional that you have travelled to a malaria-risk area, even if you took tablets and used bite precautions. Seek urgent medical advice if you become unwell with a fever after travelling in a malaria-risk area. Do not wait to see whether symptoms pass, and do not assume that taking preventive tablets rules malaria out. Tell the clinician where you travelled and when you returned. Get advice tailored to your trip At Murrayfield Pharmacy’s travel clinic in Edinburgh, a clinician can review your itinerary and personal health to help you plan malaria prevention and discuss suitable tablets. Book a malaria tablets consultation before you travel.

Flu vaccination is usually offered in Edinburgh during autumn, before flu is expected to circulate widely. Booking early gives your body time to build protection and makes it easier to arrange an appointment before winter plans become busy. Murrayfield Pharmacy provides flu vaccination appointments, with a clinician able to discuss your suitability and answer questions before vaccination. When should I book a flu vaccination? For most people, autumn is the best time to be vaccinated. The timing of each year’s programme can vary, and NHS Scotland advises eligible people when and where to get their NHS vaccination. If you are eligible, follow the timing in your invitation or check current guidance with your GP practice or NHS Inform. Protection takes around two weeks to develop, so it is sensible not to leave vaccination until flu is already circulating. However, if you have not been vaccinated earlier in the season, it may still be worth asking about an appointment later in winter. A pharmacist can advise whether vaccination is appropriate and available at that point. Flu viruses change over time, and the vaccine is reviewed for each season. Protection can also reduce over time, so last year’s vaccination does not replace this season’s dose. Annual vaccination is recommended for people who are eligible. Who is offered a flu vaccine? The NHS flu programme is designed to protect people who are more likely to become seriously unwell or to need hospital care if they catch flu, as well as certain groups who may pass it on to people at higher risk. Eligibility can change, so check the current Scottish guidance rather than relying on an old invitation. NHS vaccination is commonly offered to groups such as older adults, pregnant people, people with certain long-term health conditions, and some carers and health or social care workers. Children may also be offered vaccination through the school or community programme. The exact groups and arrangements depend on the season. If you are not sure whether you qualify for an NHS vaccine, check with your GP practice or NHS Inform. A private pharmacy appointment may be another option for people who are not eligible through the NHS, subject to the pharmacy’s service criteria and vaccine availability. When booking at Murrayfield Pharmacy, ask whether your appointment is NHS-funded or private and confirm any age or eligibility requirements. What happens at the appointment? Your appointment starts with a brief discussion about your health and vaccination history. The pharmacist will check that the vaccine is suitable for you, ask about allergies or previous reactions, and give you an opportunity to raise concerns. If you are unsure about a medicine, condition or past reaction, mention it before the injection. The vaccine is usually given as an injection into the upper arm. The appointment itself is generally brief. You can normally carry on with everyday activities afterwards, although you may prefer to take it easy if you feel tired or have a sore arm. Tell the clinician before vaccination if you: have had a serious allergic reaction to a flu vaccine or one of its ingredients; have a condition or treatment that affects your immune system; have previously had a significant reaction after vaccination; or are currently unwell with a high temperature. A mild cold without a high temperature does not necessarily mean you need to delay vaccination, but the clinician can advise based on how you feel and your circumstances. If you have a severe egg allergy or another specific allergy, discuss this when booking so the appropriate advice can be given. Possible side effects Most people have no serious problems after a flu vaccination. Some experience a sore, red or slightly swollen area where the injection was given. A short-lived headache, aching muscles or mild temperature can also occur. These effects usually settle within a few days. The injected flu vaccine cannot give you flu. If you become unwell soon after vaccination, it may be due to another infection or because you were exposed to flu before your protection had developed. As with any medicine, a serious allergic reaction is possible but uncommon. Seek urgent medical help if you develop severe breathing difficulty or swelling of the face or throat after vaccination. What the vaccine can and cannot do Flu vaccination reduces the chance of getting flu and of becoming seriously ill from it, but it is not a guarantee that you will avoid infection. It does not protect against every virus that causes coughs, colds or COVID-19. You can still catch another respiratory infection after vaccination, and it is sensible to stay at home if you are unwell and follow current infection-control advice. People with long-term conditions, those who are pregnant, older adults and people with weakened immune systems may be at greater risk from flu complications. If you are in one of these groups, ask your GP or pharmacist about vaccination even if you feel well. If you develop severe symptoms or are concerned about your health after catching flu, contact your GP or NHS 24 for advice; seek emergency help for a medical emergency. Arrange your flu vaccination in Edinburgh Booking in autumn is a practical way to plan ahead, but you can ask about vaccination later in the season too. Check the current NHS eligibility rules if you hope to receive an NHS vaccine, and confirm the appointment details and availability with the pharmacy before travelling. To discuss your options and arrange an appointment at Murrayfield Pharmacy, book your flu vaccination.

A blocked ear or muffled hearing can make conversation, work and everyday activities more difficult. Ear wax is one possible cause, particularly when symptoms develop gradually, but it is not the only one. A professional assessment can help establish whether wax is responsible and whether removal is appropriate. Knowing when to seek help — and what to avoid doing at home — can protect your ears and help you get the right care. How ear wax can affect hearing Ear wax, or cerumen, is a normal substance that helps protect the ear canal by trapping dust and other particles. Usually, it moves towards the opening of the ear naturally and falls away. In some people, it builds up and becomes impacted, partly or completely blocking the canal. An accumulation of wax may cause: A blocked or full feeling in one or both ears Muffled or reduced hearing Ringing or buzzing sounds (tinnitus) Earache or discomfort Occasionally, dizziness or coughing Symptoms can be more noticeable after using cotton buds, wearing hearing aids or earplugs, or following a shower or swim, when wax may swell or be pushed further into the canal. Some people naturally produce more wax or have narrower ear canals, making build-up more likely. Not every blocked ear is caused by wax A feeling of pressure or reduced hearing can also be associated with an ear infection, fluid behind the eardrum, a cold, changes in air pressure, or another ear condition. Sudden hearing loss can have causes that need prompt medical assessment. It should not be assumed to be wax, even if the ear feels blocked. Seek urgent medical advice if your hearing has reduced suddenly, particularly if this happened over a short period or is affecting one ear. Contact NHS 24 on 111 or seek urgent care for severe pain, discharge or bleeding from the ear, significant dizziness, or symptoms following an injury. If you feel very unwell, seek emergency help. When to consider professional ear wax removal Consider arranging an assessment if you have persistent muffled hearing or a blocked sensation that is affecting daily life, and you think wax may be the cause. A clinician can ask about your symptoms and ear history and examine the ear canal to check whether wax is present and whether it is safe to remove. This matters because treatment is not suitable for every ear or every cause of hearing difficulty. Professional removal may also be worth discussing if wax build-up is affecting the use of hearing aids or if you have recurring problems. If you have a history of ear surgery, a perforated eardrum, grommets, or ongoing ear problems, mention this before any treatment. The appropriate approach depends on your individual circumstances and the findings at assessment. What you can do safely at home If you have no warning symptoms or relevant ear history, softening drops may help wax move out naturally or make removal easier. Follow the product instructions and ask a pharmacist or clinician for advice if you are unsure which product is suitable. Do not use drops if you have been told you have a perforated eardrum, have grommets, or have had ear surgery unless a clinician has advised you to do so. If you have pain, discharge or a suspected infection, seek advice before putting anything in the ear. Avoid inserting cotton buds, fingers, hairpins or other objects into the ear canal. These can push wax deeper, irritate or injure the canal, and may damage the eardrum. Ear candles are not a safe or reliable way to remove wax. Do not try to flush your ears yourself with a home device unless a healthcare professional has confirmed that it is suitable for you and explained how to use it safely. What to expect from a professional appointment At an ear wax removal appointment, a clinician will assess your symptoms and check the ear before recommending next steps. If wax is present, they can discuss whether removal is appropriate and explain the method available, what it involves and any relevant risks. The best option depends on factors such as your ear health, medical history and the position and amount of wax. Removal may not be possible or advisable at the first appointment. Wax sometimes needs softening beforehand, or the clinician may recommend a different assessment if symptoms suggest another cause. If the ear canal is clear but hearing remains muffled, you may need further medical advice rather than wax treatment. After removal, hearing may feel clearer if wax was the cause, though this cannot be guaranteed. Get further advice if symptoms continue, return quickly, or worsen. Avoid putting objects into your ears to prevent future build-up or injury. Book ear wax removal in Edinburgh If blocked ears or muffled hearing are affecting you, Murrayfield Pharmacy offers ear wax removal at 115 Corstorphine Road, Edinburgh. Book an appointment to discuss your symptoms and find out whether professional removal is suitable for you. Book ear wax removal

Hepatitis A is an infection of the liver that can be caught through contaminated food or water, or close contact with someone who has the virus. It is more common in some parts of the world than in the UK, so vaccination may be recommended before travel. The right advice depends on your destination, itinerary and health. Planning ahead gives you time to build protection and complete the vaccine course. What does hepatitis A vaccination protect against? The hepatitis A virus is usually spread when tiny amounts of infected faeces reach a person’s mouth. This can happen through contaminated food or water, or through close personal contact. Travellers may be exposed even if they stay in comfortable accommodation or eat at reputable restaurants, as safe water and food handling cannot always be guaranteed. Hepatitis A can cause symptoms including tiredness, nausea, abdominal discomfort, fever and jaundice (yellowing of the skin or whites of the eyes). Some people, particularly children, may have mild symptoms or none at all, but adults can become significantly unwell. The illness can last for weeks, and recovery may take longer. Vaccination is a practical way to reduce the risk of infection before travel. Who should consider the vaccine? Hepatitis A vaccination is commonly advised for people travelling to destinations where the virus is more widespread. This includes many countries in Africa, Asia, the Middle East, Central and South America, and parts of Eastern Europe. Recommendations can vary within a country and change according to your plans, so it is best to discuss your specific itinerary with a travel health professional. Your need for vaccination may be greater if you will be staying with local people, visiting rural areas, travelling for a long period, backpacking, or staying somewhere with limited access to safe food and water or medical care. It may also be worth considering for shorter trips: exposure can happen during an ordinary holiday, not only on an adventurous or extended journey. Some health conditions make hepatitis A more concerning. People with chronic liver disease may be at increased risk of serious consequences if infected. A clinician may also recommend vaccination for people with certain other health or personal risk factors. Children travelling to affected areas may be eligible from one year of age; younger children need individual advice. If you are unsure whether vaccination is appropriate for you or your child, a travel consultation can help assess the risks. When should you book? Book as early as possible once you know you are travelling, ideally several weeks before departure. This allows time to assess your needs, receive a first dose and plan any follow-up doses. The vaccine is still worth discussing if your trip is soon: protection may begin after the first dose, and a clinician can advise whether vaccination is appropriate for your departure date and circumstances. Do not assume that it is too late to seek advice because you have already booked your flights. Tell the clinician when you leave, where you are going, how long you will stay and whether you have had hepatitis A vaccination before. If you have an old vaccination record, bring it or have the details available. A previous dose may affect what you need next. How many doses are needed? For most people, hepatitis A vaccination involves an initial dose followed by a second dose, usually six to twelve months later, to complete the course. The exact timing depends on the vaccine used and your individual circumstances, so follow the schedule given by your clinician. The second dose is important for longer-lasting protection, even if you feel well protected after the first. If you have received hepatitis A vaccine in the past, you may not need to start again. A clinician can review your history and advise whether a further dose is due. Travellers with particular medical conditions, including some people with weakened immune systems, may need a tailored plan or additional advice. Mention any long-term conditions and medicines during your consultation. Safety and practical points Hepatitis A vaccines used in the UK are inactivated vaccines. Common effects are usually mild and short-lived, such as soreness or redness where the injection was given, headache or feeling tired. As with any vaccine, serious allergic reactions are possible but uncommon. Tell the clinician about any previous reaction to a vaccine, allergy to a vaccine component, current illness, pregnancy or breastfeeding before vaccination. Pregnancy does not automatically rule out hepatitis A vaccination. If travel exposure is a concern, a clinician can weigh the likely benefits against any individual considerations. If you have a significant fever or feel acutely unwell, vaccination may need to be postponed until you have recovered; mention this when arranging your appointment. Vaccination is not a substitute for careful food and water precautions. During travel, wash your hands with soap and clean water before eating and after using the toilet. Follow local advice on drinking water and ice, and take care with food that is raw, undercooked or has been kept at an unsafe temperature. These measures also help reduce the risk of other travel-related infections. Getting advice in Edinburgh A travel health consultation can review your destination, previous vaccinations, health conditions and departure date, then help you decide whether hepatitis A vaccination is appropriate. It is useful to bring your itinerary and any available vaccination records. If you are travelling with family, ask about each person individually, as age and health history can affect the advice. Book hepatitis A vaccination For practical advice before your trip, book a hepatitis A vaccination appointment with Murrayfield Pharmacy in Edinburgh.

Vitamin B12 injections can be an effective treatment when they are appropriate, but tiredness or low energy alone does not show that someone has a B12 deficiency. An assessment helps establish whether treatment is likely to help, whether tests or further medical review are needed, and which approach is suitable. It can also reduce the risk of overlooking another cause of symptoms. What vitamin B12 does Vitamin B12 is needed for healthy red blood cell production and the normal function of the nervous system. A deficiency can develop gradually, so symptoms may be subtle at first. Possible symptoms include fatigue, weakness, a sore or red tongue, pale skin, pins and needles, numbness, problems with balance, and changes in memory or concentration. These symptoms are not specific to B12 deficiency. Fatigue, for example, can have many causes, and neurological symptoms may need prompt assessment. A person can also have nerve-related symptoms without the anaemia sometimes associated with B12 deficiency. An assessment considers the whole picture rather than relying on one symptom. Why an assessment comes before an injection Before treatment, a clinician can ask about your symptoms, health and diet, any previous B12 results, and medicines or supplements you take. This helps determine whether B12 deficiency is plausible and whether an injection is the right next step. It also gives you an opportunity to mention allergies or any previous reaction to an injection. Where appropriate, blood tests can help confirm deficiency and guide treatment. It is usually helpful to take blood samples before starting B12 replacement, because supplements or injections can alter B12 levels and make results harder to interpret. Tell the clinician if you have already taken B12, including tablets, multivitamins or injections. Do not delay urgent medical care in order to arrange a test. If deficiency is suspected alongside significant neurological symptoms or severe anaemia, prompt medical assessment matters. A clinician may recommend treatment without waiting for all results, depending on the circumstances. The important point is that symptoms and test results should be interpreted together, with timely care where needed. What may cause low B12? Assessment also looks for a possible reason for deficiency, as this can affect the best treatment and whether ongoing monitoring is needed. B12 is found naturally in foods such as meat, fish, eggs and dairy products. A diet that contains little or none of these foods may increase the risk, particularly if suitable fortified foods or supplements are not used. Some people have difficulty absorbing B12 even when their diet contains enough. Possible factors include certain stomach or bowel conditions, previous surgery affecting the stomach or intestine, and autoimmune conditions that interfere with absorption. Some medicines, including metformin and medicines that reduce stomach acid, can also be relevant. Do not stop a prescribed medicine without speaking to the clinician who manages it. Finding a likely cause is useful because a dietary shortfall and a problem with absorption may call for different plans. It can also identify when further investigation by a GP or another clinician is advisable. Are injections right for everyone? Not necessarily. The most suitable treatment depends on the confirmed or suspected cause, the severity of symptoms, absorption, and your medical history. In some cases, oral B12 may be suitable; in others, injections may be recommended. A clinician can explain the options and whether a pharmacy injection service is appropriate for you. An injection is not a general treatment for tiredness, and it should not replace investigation of ongoing or unexplained symptoms. If assessment suggests another cause, or that your symptoms need a different level of care, you may be advised to contact your GP or another healthcare professional. This is a practical part of safe treatment, not a reason to dismiss your concerns. What happens during a B12 injection appointment? Your clinician will review relevant health information and discuss whether the service is suitable. If an injection is appropriate, it is given into a muscle. You can ask what to expect, mention any concerns, and discuss any previous reactions or relevant allergies beforehand. As with any injection, temporary discomfort or bruising can occur; serious reactions are uncommon, but tell the clinician about any new or concerning symptoms afterwards. One injection may not be the complete treatment plan. The schedule and need for continuing treatment depend on the reason for deficiency and clinical advice. If you have already been prescribed a particular course, bring details of it to your appointment. Follow the plan recommended for you rather than arranging repeat injections solely because symptoms have returned. When to seek medical advice Arrange medical advice if you have persistent symptoms that concern you, particularly numbness, weakness, problems walking or balancing, or changes in memory. Sudden or rapidly worsening symptoms need urgent medical attention. If you have been diagnosed with B12 deficiency, keep any recommended follow-up appointments so that your response and ongoing needs can be reviewed. An assessment before treatment helps make a B12 injection more than a quick response to a symptom: it checks whether the treatment fits, whether further tests are needed, and whether another cause should be considered. For people in Edinburgh, Murrayfield Pharmacy offers a vitamin B12 injection service with clinical assessment before treatment. Book a vitamin B12 injection assessment If you would like to discuss whether a B12 injection is suitable for you, book a vitamin B12 injection appointment with Murrayfield Pharmacy.

Typhoid is a serious infection caused by bacteria that can spread through food or water contaminated by an infected person. The risk varies between destinations and depends on your itinerary, accommodation and activities. A travel health consultation can help you decide whether vaccination is appropriate and when to arrange it before departure. Who should consider typhoid vaccination? Typhoid vaccination is generally considered for travellers going to places where sanitation and food hygiene may be unreliable, or where access to safe drinking water is limited. Risk is particularly relevant in parts of South Asia, but it can also apply in other regions depending on local conditions and your plans. You may be advised to have the vaccine if you are: Visiting friends or relatives, especially if you will stay in a local home or spend time in areas with limited sanitation. Travelling for an extended period, visiting several locations or spending time outside major tourist areas. Planning to eat or drink in settings where hygiene standards may be uncertain. Going on an adventurous trip where access to safe food, water or medical care may be limited. Returning regularly to a destination where you have an ongoing risk of exposure. Children travelling to areas where typhoid is a concern may also need vaccination. The suitable vaccine and its timing depend on the child’s age and health. A clinician can review each traveller’s plans, including children and adults travelling together, rather than relying on a destination name alone. What protection does the vaccine provide? Typhoid vaccination reduces the risk of typhoid fever but does not provide complete protection. It also does not protect against paratyphoid fever, another infection that can cause similar symptoms. Care with food and water remains important, even after vaccination. While travelling, choose food that is thoroughly cooked and served hot, wash or sanitise your hands before eating, and use safe drinking water. Be cautious with ice, unpasteurised dairy products and raw foods that may have been washed in unsafe water. If you develop a high temperature or feel seriously unwell during or after travel, seek medical advice and tell the clinician where you have been. When should you book? Book a travel health appointment as early as you can, ideally several weeks before departure. This gives time to review your itinerary, check your previous vaccinations and arrange any other travel health measures you may need. It is still worth seeking advice if your trip is closer: a clinician can discuss what is appropriate within the time available. For the injectable typhoid vaccine, it is generally recommended to have the dose at least two weeks before potential exposure. This allows time for an immune response to develop. If you have been vaccinated before, tell the clinician when you received the dose; a booster may be recommended if you remain at risk and enough time has passed. An oral typhoid vaccine is also available in some circumstances. It involves a course of capsules taken on a schedule, so it needs planning too. It is not suitable for everyone and can be affected by certain medicines, including some antibiotics. The clinician can advise whether it is suitable and explain the exact instructions. Do not assume that an oral course can be started or completed at the last minute. What happens at a travel health appointment? Your clinician will ask about your destination, travel dates, length of stay, accommodation and planned activities. They will also check your age, medical history, medicines, allergies and previous typhoid vaccinations. These details help determine whether vaccination is recommended and which option is appropriate. Let the clinician know if you are pregnant, have a weakened immune system, are receiving treatment that affects immunity, or have recently taken antibiotics. These factors can affect the choice of vaccine or its timing. If you are travelling with children, provide their ages and vaccination history as well. Like other vaccines, the typhoid vaccine can cause side effects. These are usually mild and short-lived, such as soreness at the injection site or feeling slightly unwell. Your clinician can explain what to expect and what to do if you have concerns after vaccination. Planning your wider travel health Typhoid vaccination is only one part of preparing for a trip. Depending on your destination and activities, you may need other vaccinations, malaria prevention or advice about altitude, insect bites and travellers’ diarrhoea. Some vaccines require several doses, so an early appointment is helpful even if you are unsure what you need. Bring any available vaccination records and details of your itinerary to your appointment. If plans change, or you add another country to your trip, seek updated advice: health risks can differ between regions within the same country. Book a typhoid vaccination appointment For personalised advice before you travel, book a consultation with Murrayfield Pharmacy in Edinburgh. The clinician can review your plans, discuss whether typhoid vaccination is suitable and advise on timing. Book your typhoid vaccination appointment.

Blood pressure monitoring is a simple, non-invasive way to check how strongly your blood is pressing against the walls of your arteries. High blood pressure, or hypertension, often causes no noticeable symptoms, but over time it can increase the risk of heart disease, stroke, kidney disease and other complications. Regular, accurate measurements can help identify a possible problem early and support informed conversations with a pharmacist, GP or other healthcare professional. At Murrayfield Pharmacy, blood pressure monitoring provides a convenient opportunity to have your reading checked and to discuss what the result may mean. It is suitable for people who have never had their blood pressure checked, those monitoring an existing condition, and individuals who have been advised to keep a closer eye on their readings. What blood pressure numbers mean A blood pressure reading contains two numbers, recorded in millimetres of mercury (mmHg). For example, a reading may be written as 128/78 mmHg. The systolic pressure is the upper number. It measures the pressure in your arteries when your heart contracts and pumps blood around your body. The diastolic pressure is the lower number. It measures the pressure in your arteries while your heart relaxes between beats. Blood pressure naturally changes throughout the day. It can be affected by activity, stress, pain, caffeine, smoking, illness, sleep and some medicines. One reading is therefore not always enough to establish whether you have hypertension. If a result is raised, repeat measurements or home monitoring may be recommended. In a clinical setting, a reading of 140/90 mmHg or higher is generally considered raised and may require further assessment. For home blood pressure monitoring, an average of 135/85 mmHg or higher is commonly used as the threshold for suspected hypertension. These figures are based on guidance from the National Institute for Health and Care Excellence (NICE), but your personal target may differ if you have certain medical conditions or are taking blood pressure treatment. How to prepare for a blood pressure check A little preparation can make your reading more reliable. Before your appointment or measurement: Avoid strenuous exercise for around 30 minutes beforehand. Do not smoke or use nicotine immediately before the check. Avoid caffeine for at least 30 minutes beforehand where possible. This includes coffee, tea, energy drinks and some pre-workout products. Empty your bladder before the measurement. Allow yourself a few minutes to sit quietly and settle, particularly if you have walked to the pharmacy. Wear clothing that allows the cuff to be placed directly around your upper arm rather than over thick clothing. You should continue taking prescribed medicines unless a healthcare professional has specifically told you not to. Do not stop or alter blood pressure treatment based on a single reading. If you use medicines, supplements or remedies that may affect blood pressure, mention them during your appointment. What happens during monitoring? You will usually be asked to sit with your back supported and both feet flat on the floor. Your arm should rest comfortably on a table or support, with the cuff positioned at approximately heart level. Try not to talk or move while the monitor is taking the reading. The cuff should fit correctly around your upper arm. A cuff that is too small or too large can affect accuracy, so tell the person carrying out the check if the cuff feels particularly tight or uncomfortable. A reading may be taken in both arms on some occasions, especially when establishing a baseline or investigating a difference between arms. It is common to take more than one measurement, with a short pause between readings. This helps reduce the influence of temporary factors such as anxiety or movement. If your reading is unexpectedly high, it may be repeated after you have rested. The result should be considered alongside your age, health, medicines, symptoms and previous readings. Understanding high, low and changing readings A raised reading does not automatically mean that you have hypertension. Some people experience higher readings in a healthcare setting, sometimes called the white-coat effect. Others may have normal readings in the clinic but raised blood pressure at home. This is why a healthcare professional may suggest a series of home readings or ambulatory monitoring over 24 hours. Low blood pressure is not necessarily a problem if you feel well. However, readings may need attention if they are associated with dizziness, fainting, blurred vision, unusual weakness, confusion or repeated falls. Dehydration, blood loss, infection and some medicines can contribute to low blood pressure. Seek advice if low readings are persistent or causing symptoms. When taking readings at home, use a validated upper-arm monitor if possible and follow the manufacturer’s instructions. Take measurements at consistent times, seated and rested, and record the date, time, readings and any relevant symptoms. Avoid taking repeated measurements every few minutes because this can increase anxiety and make the results harder to interpret. When to seek medical advice Arrange a routine appointment with a GP or healthcare professional if your readings are repeatedly raised, if you have been advised to monitor your blood pressure, or if you are concerned about symptoms or treatment. People with diabetes, kidney disease, cardiovascular disease, a history of stroke or pregnancy may need individual advice and different thresholds. Very high blood pressure requires prompt attention. If a reading is around 180/120 mmHg or higher, sit quietly and repeat it after a few minutes. Contact NHS 24 on 111 or seek urgent medical advice if it remains very high, even if you feel well. Call 999 or attend A&E immediately if a very high reading occurs with symptoms such as chest pain, severe breathlessness, sudden weakness or numbness, difficulty speaking, confusion, a severe headache, vision loss or other sudden neurological symptoms. Do not wait for a pharmacy appointment in this situation. During pregnancy or after giving birth, high blood pressure with symptoms such as severe headache, visual disturbance, pain below the ribs, sudden swelling or feeling very unwell requires urgent maternity or medical advice. Why choose pharmacy

Rabies is a serious viral infection affecting the brain and nervous system. It is usually transmitted through the bite or scratch of an infected mammal, or when saliva enters broken skin, the eyes or mouth. Once symptoms develop, rabies is almost always fatal, but infection can be prevented if appropriate treatment is given promptly. Rabies vaccination can reduce the risk for travellers who may be exposed, although it does not replace careful animal avoidance or urgent medical assessment after an incident. Who should consider rabies vaccination? Rabies vaccination is not required for every traveller. It is recommended based on your destination, activities, length of stay and how quickly reliable medical care could be reached. A travel health consultation can help assess your individual risk rather than relying on destination alone. Pre-travel vaccination may be particularly suitable if you: Are travelling to a country or area where rabies is present in dogs, wildlife or other mammals. Will spend an extended period abroad, especially several weeks or months. Will be travelling in rural or remote areas where access to medical facilities may be limited. Are planning activities such as cycling, running, hiking, camping, caving or backpacking, which may increase the chance of encountering animals or make medical help less accessible. Expect close contact with animals, including working with dogs, cats, monkeys, bats, wildlife or livestock. Are travelling for work in veterinary, animal-handling, conservation, laboratory or healthcare settings. Are travelling with children, who may be more likely to approach or touch animals and may not report a minor scratch or bite. Some countries have rabies in domestic dogs, while others mainly pose a risk from wildlife or bats. Even where rabies is uncommon, the availability of post-exposure treatment may be limited outside major cities. Your itinerary, accommodation and planned activities are therefore important when deciding whether vaccination is appropriate. What does the rabies vaccine cover? The vaccine helps prepare your immune system to respond to rabies virus if you are exposed. It is an inactivated vaccine, so it cannot cause rabies. Pre-exposure vaccination is designed to provide an additional layer of protection before travel and to simplify treatment if a bite, scratch or saliva exposure occurs. However, vaccination does not mean that an animal exposure can be ignored. You must still: Wash the wound immediately with plenty of soap and running water for around 15 minutes, if possible. Use an antiseptic, such as an iodine-based or alcohol-based preparation, if available and suitable. Seek urgent medical advice, even if the wound appears minor and even if you have completed vaccination. Report any bite, scratch or contact with saliva from a mammal to a healthcare professional. Rabies vaccination does not protect against other infections that may follow an animal bite, such as tetanus or bacterial wound infection. A clinician may recommend additional treatment, including a tetanus booster, antibiotics or other wound care. The vaccine also does not cover every possible cause of illness from animal contact. When should you start the vaccination course? For most healthy adults and children, the UK pre-exposure course consists of two doses. The first dose is given on day 0 and the second on day 7. Starting at least one week before travel allows time for the course to be completed and for an immune response to develop. Ideally, arrange a travel health appointment four to eight weeks before departure. This gives time to review your full itinerary, identify any other required or recommended vaccines, and deal with schedule changes or additional health needs. It may still be possible to begin the course closer to departure, but this should be discussed with a clinician. Do not delay a necessary trip without obtaining individual advice. People who are immunosuppressed may need a different schedule, including a third dose given between days 21 and 28, and may require further clinical assessment or blood testing. Tell the pharmacist about any condition or treatment that affects your immune system, including chemotherapy, high-dose steroid treatment, transplant medicines or certain biological therapies. How long does protection last? The duration of protection depends on your health, continuing exposure risk and the possibility of future travel. Routine booster doses are not required for every traveller after the standard course. A booster or antibody blood test may be considered for people with continuing occupational exposure, repeated travel to high-risk settings or medical factors affecting their immune response. If you had rabies vaccination in the past, bring any available vaccination records to your appointment. A clinician can check which product and schedule you received and decide whether further doses are indicated. Requirements can also differ for people travelling for employment or formal animal-handling duties, so workplace guidance may apply. What happens after a bite or scratch? Pre-exposure vaccination does not provide complete immunity. If you are exposed, you still need urgent post-exposure treatment. This is time-sensitive and should be arranged through local medical services in the country where the exposure occurred, followed by specialist advice when you return to the UK. For someone who has previously completed an appropriate pre-exposure course, post-exposure treatment commonly involves two further rabies vaccine doses, usually on days 0 and 3. Rabies immunoglobulin is not normally required for a previously vaccinated person. Someone who has not been vaccinated may need a longer vaccine course and rabies immunoglobulin, depending on the exposure and clinical assessment. Do not wait for symptoms. Symptoms can initially resemble a general viral illness, but once clinical rabies develops, treatment is not effective. Prompt wound cleaning and medical assessment are essential after any potentially risky exposure. Is rabies vaccination suitable for children? Rabies vaccine can be given to children when clinically indicated. Children may benefit particularly from vaccination if they are travelling to a rabies-risk area, because they may be more inclined to touch animals or may not mention a small scratch. Parents should still teach children never to approach, feed or handle unfamiliar animals, including apparently friendly dogs, cats and monkeys. Before vaccination, tell the clinician about allergies, previous vaccine

Tick-borne encephalitis (TBE) is a viral infection transmitted by the bite of an infected tick. It can cause inflammation of the brain and spinal cord, sometimes resulting in serious neurological illness. The infection is found in parts of Europe and Asia, particularly in wooded, grassy and rural areas. If you are planning hiking, camping, cycling, trekking or other outdoor activities in an affected region, TBE vaccination may be appropriate. Murrayfield Pharmacy provides private travel health consultations and TBE vaccination in Edinburgh. A clinician can assess your destination, itinerary, activities, medical history and time before travel, then advise whether vaccination and other tick precautions are recommended. Where is tick-borne encephalitis found? TBE occurs in parts of central, eastern and northern Europe, including some areas of Austria, Germany, Switzerland, the Czech Republic, Slovakia, Poland, Hungary, Slovenia, Croatia, Estonia, Latvia, Lithuania, Sweden and Finland. It is also present in parts of Russia and some areas of northern and eastern Asia. The level of risk can vary considerably within a country. It may be concentrated in particular rural, forested or mountainous areas rather than applying uniformly across the whole destination. Travel health advice can also change, so the country name alone is not always enough to determine whether vaccination is needed. Before your appointment, note the specific regions you will visit, including national parks, islands, ski areas and rural accommodation. The dates and season of travel are also relevant, as ticks are generally more active during the warmer months. Who should consider TBE vaccination? TBE vaccination is usually considered for people who will spend significant time outdoors in an affected area, especially where access to medical care may be limited. It may be suitable for: Hikers, trekkers, campers and climbers People taking walking, cycling, horse-riding or adventure holidays Those staying in rural or forested accommodation Outdoor workers, field researchers and forestry workers People travelling for extended periods or making repeated visits Travellers who may be unable to avoid tick bites because of their planned activities Short urban holidays with no planned exposure to rural or wooded areas may not require TBE vaccination. However, an itinerary that includes day trips, camping or outdoor excursions could alter the recommendation. A travel health consultation helps distinguish between a low-exposure trip and one where vaccination should be discussed. How is TBE transmitted? TBE is mainly spread through the bite of an infected tick. Ticks may be present in long grass, woodland, scrub and leaf litter. They can attach to exposed skin or clothing and may be difficult to spot, particularly when they are small. In some affected regions, infection can also rarely be acquired through unpasteurised dairy products, including milk, cheese and other products from infected animals. Avoiding unpasteurised dairy products is therefore an additional sensible precaution when travelling in a TBE-risk area. TBE is not the same as Lyme disease. Both infections can be transmitted by ticks, but they are caused by different organisms and the TBE vaccine does not protect against Lyme disease or other tick-borne infections. Tick avoidance remains important even if you have completed TBE vaccination. When should you book the vaccine? Ideally, arrange a travel health appointment several months before departure. The usual primary course involves three injections. The first two are given a few weeks to a few months apart, with the third dose given several months later. The exact timing depends on the vaccine used, your age, your travel date and the relevant product guidance. When travel is approaching soon, an accelerated schedule may be available for some TBE vaccines. This can provide earlier protection, but it is not suitable for everyone and does not remove the need to complete the course. A clinician will explain the options and advise when further doses are due. Book as early as possible if you are travelling in the next few weeks, particularly if you are planning prolonged outdoor activity. Even if there is not enough time to complete the standard course, a consultation can still be useful. You may be able to receive a first dose, discuss an accelerated schedule and receive practical advice on reducing tick exposure. How many doses are needed? Most people require a three-dose primary course for longer-term protection. The spacing between doses is important, so keep a record of each vaccination and bring details of previous TBE injections to your appointment. Booster doses may be recommended after the primary course. The timing can vary according to the vaccine product, age and current travel health guidance. Older adults may require closer review because immune responses can be less predictable with increasing age. Your pharmacist will provide an individual schedule rather than relying on a generalised timetable. TBE vaccination is not a one-off travel injection for every traveller. If you expect to return to affected areas or undertake regular outdoor work, discuss your future travel plans so that your vaccination record and booster requirements can be reviewed appropriately. What does the consultation involve? The clinician will ask about your destination, dates, accommodation, planned activities, previous vaccinations, allergies, long-term conditions and regular medicines. You should mention if you are pregnant, breastfeeding, immunocompromised, recovering from an illness or have previously experienced a serious reaction to a vaccine. Most people can be vaccinated safely, but vaccination may need to be delayed or discussed carefully in certain circumstances. The consultation is also an opportunity to review other travel health needs, such as routine vaccinations, malaria prevention, altitude sickness medication and advice about food, water and insect bites. Reducing your risk of tick bites Vaccination complements, rather than replaces, careful tick avoidance. When outdoors in an affected area: Wear long trousers, long sleeves and closed footwear. Tuck trousers into socks where practical. Use an appropriate insect repellent on exposed skin and follow the product instructions. Consider treating clothing and equipment with a suitable tick-repellent product. Keep to clear paths where possible and avoid brushing against dense vegetation. Check your skin, clothing and equipment regularly, including behind the knees, around the waist, in the groin

As the days become shorter and people spend more time indoors, respiratory infections can spread more easily. An autumn COVID-19 vaccination is designed to refresh protection before the winter season, when the risk of infection and serious illness may increase. Eligibility and vaccine recommendations can change from one season to the next, so it is important to check the current NHS Scotland guidance or speak with a qualified vaccination provider. Who is most likely to be offered an autumn COVID-19 vaccination? The seasonal programme is primarily intended for people who have a higher risk of becoming seriously unwell with COVID-19. The groups offered vaccination are set nationally and may vary according to age, health conditions and the recommendations in place for that autumn. Depending on the current programme, this may include: Older adults, with the qualifying age set for the relevant seasonal campaign. Residents of care homes or people living in other settings where there may be a greater risk of outbreaks. People with a weakened immune system because of a medical condition or treatment. Some individuals with conditions that increase their risk from COVID-19, following clinical assessment. Pregnant women, where vaccination is recommended under the current national guidance. People who provide close personal care to someone who is particularly vulnerable may also wish to ask whether they are eligible or whether a private vaccination is suitable. The arrangements for unpaid carers, health and social care workers and household contacts can differ between seasons. If you are not included in the NHS seasonal programme, you may still wish to discuss vaccination privately. A pharmacist or other qualified healthcare professional can consider your age, medical history, previous vaccinations and personal circumstances before advising whether vaccination is appropriate and available. Why is an autumn booster considered? Protection from previous vaccination or infection can reduce over time. COVID-19 viruses also continue to change, so seasonal vaccines may be updated to provide protection against strains that are expected to circulate. The purpose of an autumn vaccination is to strengthen protection before winter, particularly against severe disease, hospital admission and complications. Vaccination cannot guarantee that you will not catch COVID-19. You may still develop an infection, but vaccination can reduce the likelihood of becoming seriously unwell. This is particularly important for older people and those with conditions that affect the immune system or general health. Having had COVID-19 previously does not necessarily mean that you no longer need a seasonal vaccination. Immunity can vary between individuals, and infection does not provide dependable protection against all future variants. If you have recently been unwell, ask when it is best for you to be vaccinated. When should you have the vaccination? The autumn campaign usually begins before the main winter respiratory virus season. The best timing depends on the national programme, your eligibility and whether you have recently received another COVID-19 vaccine or had an infection. You should follow the invitation or advice provided by NHS Scotland if you are eligible. If you are arranging a private vaccination, booking earlier in the autumn may help you obtain protection before winter travel, family gatherings and increased indoor contact. However, there is usually no need to delay vaccination simply because you have not yet had a seasonal cold or because other people around you have been vaccinated. If you currently have a high temperature or feel acutely unwell, it may be sensible to wait until you have recovered. A minor illness without a fever does not always prevent vaccination, but the vaccinator will assess you on the day. If you have recently had COVID-19, the appropriate interval may depend on the current guidance and your individual risk. Can it be given with the flu vaccination? COVID-19 and flu vaccinations can sometimes be given during the same appointment. This may be convenient for people who are eligible for both, but they are separate vaccines and protect against different viruses. The decision to administer them together depends on the current programme, vaccine supply, your eligibility and clinical assessment. If you are booking appointments separately, there is generally no need to complete one vaccination course before arranging the other. Tell the healthcare professional about any recent vaccinations so that the correct timing can be confirmed. What happens at a COVID-19 vaccination appointment? Before vaccination, the healthcare professional will check your eligibility and ask about your health, allergies, previous reactions to vaccines and recent illness. You should mention if you have: Had a serious allergic reaction to a previous COVID-19 vaccine or one of its ingredients. Experienced a significant reaction after any other vaccination. Been diagnosed with a condition affecting your immune system. Recently had COVID-19, a fever or another acute illness. Received another vaccination recently. The vaccine is usually administered into the upper arm. The appointment is brief, although you may be asked to remain for observation afterwards if this is clinically appropriate. Wear clothing that allows easy access to your upper arm and bring details of relevant medicines or previous vaccination records if you have them. What side effects might you notice? Most side effects are mild and settle within a few days. You may experience soreness, redness or swelling where the injection was given, tiredness, headache, muscle aches, chills, a mild fever or feeling generally unwell. These effects are signs that your immune system is responding and are usually temporary. Rest, fluids and ordinary activities as tolerated may help. If you need advice about pain or fever relief, ask a pharmacist, particularly if you are pregnant, have a long-term condition or take regular medicines. Serious allergic reactions are uncommon, and vaccination providers are trained to manage them. Seek urgent medical help if you develop severe breathing difficulty, swelling of the face or throat, collapse or another rapidly worsening symptom after vaccination. If you are worried about a persistent or unusual reaction, contact NHS 24 on 111 or seek appropriate medical advice. Where can you arrange vaccination in Edinburgh? A local pharmacy appointment can be a convenient option for people