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Healthcare professional

If you suspect an adverse reaction has occurred, tell your physician or pharmacist. This includes any possible adverse reactions not listed in the package leaflet for the medicinal product. Please also report any abuse or improper use of a medicinal product, overdose, or if you suspect a drug interaction occurred or that the medicinal product was ineffective. By reporting adverse reactions you can help provide more information on the safety of the medicinal product. You can also report adverse reactions directly via the national system for reporting adverse reactions. You can also use this form to report suspected adverse reactions and other information concerning the safety of medicinal products.

Reporter details

The suspected adverse reaction is being reported by
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Doctor contact

Patient details

Sex

Adverse reactions

Suspected medicinal product

Repeated use of the product?
In compliance with the Regulation of the European Parliament and the European Council (EU) 2016/679 (hereinafter “GDPR”) we would like to assure you of all personal data you share with us in connection with the relevant case of suspect adverse reaction will be kept confidential and processed by PRO.MED.CS Praha a. s. (hereinafter “controller”) in order to comply with legislation on drug safety and pharmacovigilance in line with controller´s standard operating procedures. Your personal data will be used for dutiful management of the relevant case of suspect adverse reaction which includes in necessary cases the need to perform effective follow-up communication with you to ensure that complete and accurate information are collected and processed. Your personal data may be further shared with supervisory health authorities for the purpose to comply with relevant regulatory obligations. In connection with personal data processing as described in this notice you are entitled to apply at controller your right to access personal data, ask for a copy of personal data, to correct it, erase or restrict its processing and/or to lodge a complaint with a relevant data protection supervisory authority.

Contacts

You can contact us using the contact form above or at any of our addresses below. Please send all postal correspondence to our postal address: P. O. BOX 157, 140 21 Praha 4.

Registered address

PRO.MED.CS Praha a.s.

Telčská 377/1
Michle, 140 00 Prague 4
Czech Republic

Data box: cdhfuep

Office

PRO.MED.CS Praha a.s.

Za Brumlovkou 1559/5
Michle, 140 00 Prague 4
Czech Republic

phone: +420 241 013 111
fax: +420 241 013 412
email: promed@promedcs.com

PRO.MED.CS Praha a.s. has been registered in the Commercial Register maintained by the Municipal Court in Prague, Section B, File no. 3, since 1 February 1989. Organisation ID: 00147893, Tax (VAT) ID: CZ00147893.
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