Advance Health – April 2019

Arabian Ethicals Pharmacovigilance Form

Using this form healthcare professionals can report any suspected Adverse Reaction (AR), Medication Error (ME) and Adverse Event experienced from any of the drug product within the stipulated timeframe as defined in DoH policies, even if reporters are not certain that the particular medicinal product was the cause.

Unintended adverse effects, drug abuse, overdose, interaction (including drug-drug and drug-food interactions) and unusual lack of therapeutic efficacy are all considered to be reportable suspected Adverse Reactions (AR).
A. Patient Details (See Confidentiality section)
B. Medical products used:
C. Adverse Reaction
G. Reporter Details.