Pharmacovigilance

Patient health is our priority. The PIQ-PHARMA Company is responsible for the quality and safety of its products.

A pharmacovigilance system allows to take timely measures to improve the safety of drug therapy, and, as a result, improve the quality of treatment.

We constantly collect and analyze information on the safety of our medicines, aimed at identifying, evaluating, understanding and preventing unwanted consequences of their use. In this regard, in the event of adverse reactions as a result of taking PIQ-PHARMA medications, please inform the responsible specialist about them:

by e-mail: fn@pikfarma.ru by completing the notification form about adverse reaction;
by calling at free 24-hour number: 8-800-777-8-604;
by sending a message via WhatsApp, Viber to the number: +7-903-799-2-186;
by completing an application form through a free mobile application:
https://drugsafety.ru/en/research-and-trainings/mobile-app/
or fill out the form below

Date of development undesirable reactions

How can I contact you?

Phone

Suspect drug suspected of causing an adverse reaction (trade name, dosage form, dosage, route of administration, batch number): — — — Aksamon® ampules 5 mg/ml 1ml Aksamon® ampules 15 mg/ml 1ml Aksamon® tablets 20 mg Gabapentine capsules 300 mg Dibicor® tablets 250 mg Dibicor® tablets 500 mg Dibufelon® capsules 200 mg Carnicetine® capsules 295 mg Cordinic® tablets 10 mg Nooclerin® oral solution 100ml Pantogam® oral solution 100 mg/ml Pantogam® tablets 250 mg Pantogam® tablets 500 mg Pantogam® active ив capsules 300 mg Elcar® effervescent granules 1000mg Elcar® ampules 100 mg/ml 5ml Elcar® oral solution 300 mg/ml (25ml) Epilexid® syrop 50 mg/ml

Patient information (age, gender, initials)

Description of the adverse reaction (briefly, e.g. nausea, headache, drug failure):

Date of completion

Consent to the processing of personal data

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In accordance with the requirements of the Federal Law of July 27, 2006, No. 152-FZ "On Personal Data", I agree to the processing of my personal data by PIQ-PHARMA LLC without reservations and restrictions, and to take actions with my personal data provided for in cl. 3 part 1 article 3 of the Federal Law of July 27, 2006 No. 153-FZ "On Personal Data", and I confirm that, giving such consent, I act freely, of my own free will and in my own interests. I give my consent to the processing of personal data for the purpose of further cooperation with PIQ-PHARMA LLC.

The list of personal data for the processing of which consent is given: last name, first name, patronymic, place of residence (country, city, region), telephone numbers, e-mail addresses (E-mail), as well as other personal data received from me. I agree to carry out the following actions with all the specified personal data: collection, systematization, accumulation, storage, clarification (update or change), use, as well as the implementation of any other actions with personal data in accordance with applicable law. Data processing can be carried out both with the use of automation tools and without their use (with non-automatic processing). When processing personal data, PIQ-PHARMA LLC is not limited in the use of methods for their processing. This consent is valid until the date of its withdrawal by me by sending to PIQ-PHARMA LLC a corresponding written statement signed by me, which can be sent by me to PIQ-PHARMA LLC.

In case of receiving my written application to revoke this consent to the processing of personal data, PIK-PHARMA LLC is obliged to stop processing them and exclude personal data from the database, including electronic, with the exception of information about the last name, first name, patronymic.