TeleDoc

Short answer: sometimes — and it depends on the service and what you tell them. What most reputable online ED services do Use a medical questionnaire that specifically asks about heart disease, recent heart attack/stroke, blood pressure, and medications (especially nitrates and some blood-pressure drugs). Have a clinician (physician, nurse practitioner or physician assistant) review your answers before a prescription is issued. Many services explicitly screen for the main contraindications to PDE5 inhibitors (sildenafil/Viagra, tadalafil/Cialis, vardenafil/Levitra). Some services offer or require a telemedicine visit (video/phone), let you upload records, and can communicate with your primary care doctor. Typical safety checks they perform Ask if you take nitrates (nitroglycerin, isosorbide), which are an absolute contraindication because the combination can cause dangerous low blood pressure. Ask about recent myocardial infarction, unstable angina, or uncontrolled heart failure — these often warrant in-person evaluation first. Ask about blood pressure control and use of alpha‑blockers (orthostatic hypotension risk) or strong CYP3A4 inhibitors (which affect dosing). Review other medications for interactions. Limitations — when online checks may miss risks No routine ECG, blood pressure reading, or physical exam unless you provide one. Some cardiac problems are asymptomatic and won’t show up on a questionnaire. They rely on accurate self-reporting of diagnoses and medications. If you omit something (e.g., nitrates you take PRN), the clinician can’t catch it. Complex cardiac histories (recent MI, unstable angina, significant arrhythmias, severe heart failure) usually need in-person cardiology assessment. Which services tend to be more thorough PlushCare and TeleDoc/MDLive — offer video visits with a clinician who can take a history and review meds in real time. Roman (Ro), Hims, and Lemonaid — use online questionnaires plus clinician review; some let you schedule a tele-visit or upload records. If you want more continuity or integration with your records, consider services that coordinate with or are part of primary-care networks (PlushCare, your insurer’s telehealth). What I recommend you do Be explicit about heart disease, prior heart attacks/strokes, chest pain with exertion or sex, and every medication (including PRN nitroglycerin, recreational drugs, HIV protease inhibitors). Pick a service that offers a clinician review or a video visit rather than only an automated questionnaire. If you have recent cardiac events, chest pain with sex, multiple cardiac risk factors, or use nitrates — get an in‑person evaluation and ECG first. If you want, tell me the meds and heart history you’re worried about and I can point out specific interactions/contraindications (I won’t prescribe, but I can flag red flags). If you want, name the online service you’re considering and I’ll tell you how thorough their screening tends to be and what extra questions to ask.

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