Alkaloid uses the information you provide in this form solely for the purpose of monitoring of the adverse reactions, so that the adverse reaction you've reported is properly documented, assessed and reported in accordance with our legal obligations, for the purpose of identifying, assessing, understanding and preventing adverse reactions or any other risks associated with use of medicinal products. Alkaloid may be obliged to forward the submitted data to the competent authorities in accordance with legal obligations. Your personal information will not be used for any other purpose. You can find out more about privacy and personal data protection, your rights and data protection inquiries here: <a href="https://alkaloid.hr/privacy-policy" rel="noopener noreferrer" target="_blank">privacy policy</a> Personal information collected through this form will remain confidential and will be used ONLY for the purpose of determining the safety of medicinal products.Each adverse reactions report is extremely valuable; it is medically processed, added to the database of adverse reactions and becomes a permanent part of the knowledge about the safety of a particular drug.We may contact you to collect more information about the reported adverse reaction.If you have entered the contact details of your chosen family doctor, it is possible that we will contact him / her to gather more information about the reported adverse reaction. Thank you for taking the time to fill out this application form.

IF YOU ARE A PATIENT/ USER OF A MEDICINAL PRODUCT OR CAREGIVER / NON-HEALTH CARE PROFESSIONAL You can report adverse drug reactions by filling out the form on this page. Your application will be sent to us by pressing the SEND button. Please read the&nbsp;<a href="https://alkaloid.hr/terms-of-use" rel="noopener noreferrer" target="_blank" style="color: rgba(0,174,239,var(--tw-text-opacity));">Terms of Use</a><a href="https://alk-hr.sols.mk/Terms%20of%20Use%C2%A0" rel="noopener noreferrer" target="_blank" style="color: rgba(0,174,239,var(--tw-text-opacity));">&nbsp;</a>and&nbsp;<a href="https://alkaloid.hr/privacy-policy" rel="noopener noreferrer" target="_blank" style="color: rgba(0,174,239,var(--tw-text-opacity));">Privacy Policy</a>&nbsp;for more information before proceeding.

Alkaloid koristi podatke koje dajete u ovom obrascu isključivo u svrhu praćenja nuspojava, kako bi vaša nuspojava bila ispravno dokumentirana, procijenjena i prijavljena u skladu s našim pravnim obvezama,&nbsp;&nbsp;u svrhu identificiranja, procjene, razumijevanja i preveniranja nuspojava ili bilo kojih drugih rizika vezanih uz korištenje lijekova. Alkaloid može biti u obvezi dostavljene podatke proslijediti nadležnim tijelima sukladno zakonskim obvezama. Vaši osobni podaci neće se koristiti ni u koje druge svrhe. Više o zaštiti privatnosti i osobnih podataka, vašim pravima i upitima oko zaštite podataka možete saznati ovdje: <a href="https://alkaloid.hr/hr/politika-privatnosti" rel="noopener noreferrer" target="_blank">Politika privatnosti</a> Osobne informacije prikupljene ovim obrascem ostat će tajne i koristit će se JEDINO u svrhu utvrđivanja sigurnosti primjene lijekova.Svaka prijava nuspojave je izuzetno vrijedna; ona se medicinski obrađuje, unosi u bazu nuspojava i postaje trajni dio saznanja o sigurnosti primjene pojedinog lijeka.&nbsp;Moguće je da ćemo vas kontaktirati kako bismo prikupili više informacija o prijavljenoj nuspojavi.Ako ste upisali kontakt podatke izabranog liječnika obiteljske medicine, moguće je da ćemo nju/njega kontaktirati kako bismo prikupili više informacija o prijavljenoj nuspojavi Hvala vam što ste našli vremena i ispunili ovu prijavu.

AKO STE BOLESNIK/KORISNIK LIJEKA ILI SKRBNIK/NEZDRAVSTVENI RADNIK Nuspojave lijeka možete prijaviti ispunjavanjem obrasca na ovoj stranici. Vaša prijava će nam biti poslana pritiskom na tipku POŠALJI. Prije slanja pročitajte <a href="https://alkaloid.hr/hr/uvjeti-koristenja" rel="noopener noreferrer" target="_blank">Uvjete korištenja</a> i <a href="https://alkaloid.hr/hr/politika-kolacica-1" rel="noopener noreferrer" target="_blank">Pravila privatnosti</a> za više informacija.

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Report of adverse drug reactions

INFORMATION ABOUT THE REPORTER