Pharmacovigilance

Is the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problems.

Adverse Effects

Unintended effect with the drug exposure that is noxious (harmful only).

The aim of pharmacovigilance system in Misr pharmaceutical company is to continue monitoring of the drug after it is marketed to ensure benefit/ risk balance of the drug profile, by continues reporting of any adverse drug reactions appear from any of our products and detect its seriousness and connecting the data to Egyptian Pharmaceutical Vigilance Center (EPVC).

Pharmacovigilance department in Misr pharmaceutical Co responsible for continues training to all members of the company on how reporting to any adverse drug reactions and/ or other drug related problems of company products.

Misr pharmaceutical co it's our mission that produce drugs of high quality, efficacy and safety.

You may report any Adverse drug reaction or any drug related problems concerning Misr Medicinal products through:

E-mail: pharmacovigilance@misrpharma.com.eg
Mobile No.: 01050496895

                                                                                                                                      Be Vigilant

Send Us your Complaint

Reporter data

Date

Name

Governate Cairo Giza Alexandria Dakahlia Red Sea Beheira Fayoum Gharbiya Ismailia Menofia Minya Qaliubiya New Valley Suez Aswan Assiut Beni Suef Port Said Damietta Sharkia South Sinai Kafr Al sheikh Matrouh Luxor Qena North Sinai Sohag

Phone Number

Reporter Doctor Patient Pharmacist Nurse Other

Patient data

Patient's initials

Sex Male Female

Weight (KG)

Age or age group Age Age group

Age

Age with Day Month Year

Age group Fetus Infant Child Teenager Adult Elderly

Suspected pharmaceutical product

Name of the product

Concentration

Dosage

Usage

Start date (year) Fill out the date completely if possible. If you do not remember the specific date, it is possible to choose a month and a year or just a year

Start date (month) 1 2 3 4 5 6 7 8 9 10 11 12

Start date (day) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Date or period of cessation of use Date of cessation of use Period of use

Date of cessation of use

Period of use

Period of use with minute hour Day Month Year

Reason for using the product

What action was taken? Stop the medication Reduce the dose Increase the dose Do not change the dose I don't know

Has the product caused a similar reaction before? Yes No I don't know

Do you want to add another product? Yes No

The second suspected medical preparation

Name of the product

Concentration

Dosage

Usage

Start date (year) Fill out the date completely if possible. If you do not remember the specific date, it is possible to choose a month and a year or just a year

Start date (month) 1 2 3 4 5 6 7 8 9 10 11 12

Start date (day) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Date or period of cessation of use Date of cessation of use Period of use

Date of cessation of use

Period of use

Period of use with minute hour Day Month Year

Reason for using the product

What action was taken? Stop the medication Reduce the dose Increase the dose Do not change the dose I don't know

Has the product caused a similar reaction before? Yes No I don't know

Suspected adverse effects

Description of the adverse effect Write a brief description (headache or diarrhea for example) of each reaction you have experienced and relevant details

Date the adverse effect started (year) Fill out the date completely if possible. If you do not remember the specific date, it is possible to choose a month and a year or just a year

Date the adverse effect started (month) 1 2 3 4 5 6 7 8 9 10 11 12

Date the adverse effect started (day) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Patient's condition now Recovered Recovering The adverse effect continues Recover with complications

The date or the duration the adverse effect stopped Date the adverse effect stopped The duration of the adverse effect

Date the adverse effect stopped

The duration of the adverse effect

The duration of the adverse effect with minute hour Day Month Year

Did the adverse effect cause any of the following? Caused death Life threatening Causing the patient to be hospitalized Causing a prolongation of the length of stay in the hospital It causes birth defects in fetuses Causes permanent disability Requires medical or surgical intervention to prevent disability or permanent damage أخرى

other notes

Do you want to add another reverse effect? Yes No

Other medications taken List other medications taken during (concurrently with) the medication in question

Suspected adverse effects

Description of the adverse effect Write a brief description (headache or diarrhea for example) of each reaction you have experienced and relevant details

Date the adverse effect started (year) Fill out the date completely if possible. If you do not remember the specific date, it is possible to choose a month and a year or just a year

Date the adverse effect started (month)) 1 2 3 4 5 6 7 8 9 10 11 12

Date the adverse effect started (day) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

The date or the duration the adverse effect stopped Date the adverse effect stopped The duration of the adverse effect

Date the adverse effect stopped

The duration of the adverse effect with

The duration of the adverse effect with minute hour Day Month Year

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