AEC Cultural Showcase - Switzerland

At Arabian Ethicals, we like to highlight our cultural diversity. We kicked off the AEC Cultural Showcase with a celebration of all things Swiss! The lone Swiss at Arabian Ethicals, our GM Stephan Stauffer, proudly shared with us how beautiful Switzerland is–from their picturesque alps, history, culture and passed around yummy Swiss chocolates and raclette cheese!

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)

Health Care Institution:

B. Medical products used:

Medical product Name “Generic & Brand” (Manufacturer and Batch No. if known)

Dose, Route and Frequency

Therapy Starting Date

Therapy Stopping Date

Description of the reaction(s):

Onset date of reaction:

End date of reaction:

Action taken towards Adverse Reaction:

Reaction abated after use stopped or dose reduced:

Yes No Not applicable

Reaction reappeared after reintroduction:

Yes No Not applicable

Treatment of Adverse Reaction:

No Yes(medications and/or other therapy) include dates

Relevant tests / laboratory data including dates:

Other relevant History, including pre-existing medical conditions (e.g. allergies, pregnancy, smoking, renal dysfunction etc)

D. Outcome of Adverse Reaction

Recovered Recovering No improvement Unknown

E. Seriousness of Adverse Reaction:

Serious (If yes, tick all applicable below) Non serious

F. If this is a follow up report of an already reported AR case, please tick this box

G. Reporter Details.

(Name and complete address)

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Arabian Ethicals Pharmacovigilance Form