Report adverse reactions

If you would like to report an adverse reaction, please contact the Pharmacovigilance Department.

Below you can choose the form in which you would like to file the report.  

If you want to get medical advice, please contact a healthcare professional.

Report sent

Error occured, report has not been sent

Send online report
Download report form
1
2
3

1. Online report

2. Data of the patient who experienced adverse reaction

Sex

Pregnancy and breast-feeding

Pregnancy

Breast-feeding

  1. Download the Adverse Drug Reaction Report by clicking the below button
  2. Print the Report and fill in the required information
  3. Scan or take a high-quality photo of the Report and then send it to the Pharmacovigilance Department to the below address:

Biofarm Sp. z o.o.
Ul. Wałbrzyska 13
60—198 Poznań, Poland

Telephone number: +48 61 66-51-526
Fax: +48 61 66-51-630
e-mail: pharmacovigilance@biofarm.pl

Download the adverse reaction report