A notice
on adverse reactions (PR) and / or lack of efficacy (OE)
medicinal product (medicinal product) during its medical application

    The key task of Biopharma is to provide consumers with effective and safe medicines. Therefore, we will be grateful for providing reliable information on the detection of adverse effects or the lack of efficiency of our products. This will help us to improve the Biopharma drugs.

    01. General information



    Sexmalefemale




    description of AR/ indicate LE of the MP *

    (including data on laboratory and instrumental studies related to AR)

    Consequences of AR/LE * RecoveryRecoveringNo changeUnknownRecovery with consequencesDeath not due to ARDeath, possibly due to ARDeath due to AR
    AR/LE category * Patient deathLife threateningOutpatient hospitalizationProlongation of hospitalizationlong-term disability, invalidityCongenital malformationsAnother important medical evaluationNone of the above

    02. Suspected drug information (SDI)








    03. Information about concurrent drugs








    04. AR correction measures

    Was suspected drug cancellation accompanied by the termination of AR?

    yesno


    Increase/decrease, indicate increment


    Is there a recurrance of AR after re-appointment of the suspected drug?

    yesno

    Is there a recurrance of AR after сhange of suspected drug dosage?

    yesno

    AR/LE Correction of AR/Le was not conductedDrug treatment of AR/LE

    Specify the drug, dose regimen, duration of appointment

    05. Reporter information




    Reporter of AR/LEPhysicianPharmaceutistQualified Pharmaceutical ChemistNurseBiopharma employeeother