Pharmacovigilance

Report side effects

Help us improve product safety by reporting any suspected adverse reactions. Your contribution supports continuous safety monitoring and protects public health.

Safety is our priority

Each report contributes to ongoing safety evaluation and risk minimization.

Data protection

All submitted information is handled confidentially and used exclusively for pharmacovigilance and public health purposes.

Your contribution matters

Your reports help improve healthcare quality and patient safety.

Pharmacovigilance Reporting Form

Please complete the form below to report suspected adverse reactions. Fields marked with * are mandatory.

Personal information

Full name *

Age *

Gender *

Weight (kg)

Contact (Email or Phone) *

Medication information

Name of the medication *

Doses *

Administration road *

Start date of use

End of use date

Reason for use

Side effect information

Side effect description *

Date side effect began

Degree of importance *

The result *

Other medications you use

Other information

Reporter type *

Other information

I agree that my data will be used for scientific and health protection purposes. *

I agree to be contacted for further follow-up if necessary.

Any questions?

If you have questions about pharmacovigilance or need assistance in completing the form, do not hesitate to contact us.

Phone Number

+355 69 408 8818

Email

pv@uniquepharmaceuticals.al