The real concern for your future

Pharmacovigilance

Following ethical principles and requirements of Russian legislation, the company Pharm-Sintez collects security information, processes it, evaluates and brings to the attention of regulators and physicians.

If in the process of applying Pharm-Sintez medical products you experience any adverse events and/or you have claims to company products quality, and, if You become aware of adverse events affecting other consumers when using Pharm-Sintez products, please e-mail at npr@pharm-sintez.ru or call on + 7 (495) 796-94-33. Also to send the message about the adverse event you can fill out the form below.

The company JSC "Pharm-Sintez" cares about the high quality of their products and therefore interested in receiving any information on safety in order to further assess and mitigate the risk of adverse reactions in patients.

Adwerse event information source

Full Name*

Position and place of work

Address of institution

Phone

Date of receipt of the information*

Date of receipt of the information*

Patient Information

Initials*

Number of ambulatory card or medical history

Gender*

Age (s)*

Weight (kg)*

Pregnancy*

Allergy*

Abnormal liver function

Impaired renal function

Treatment

The medicine (PM) № , allegedly caused by HP

International name (INN)

Trading name*

Manufacturer*

A country*

Serial*

Indications for

The route of administration

Single / daily dose

Date of commencement of therapy

Date of completion of therapy

The dose causing HP

Other drugs taken during the last 3 months, including drugs taken by patients on their own (in its sole discretion)

used

Information about adverse reaction

Description HP*

Start date HP*

Date of authorization*

A cancellation if accompanied with the disappearance of HP?*

It is noted a repeat of HP after the re-appointment of PM?*

The measures

HP Medication (if needed)

Exodus*

The criterion of seriousness (tick if appropriate)*

Significant additional information