According to the definition of the World Health Organization, ADR or adverse drug reaction is any adverse and adverse reaction that occurs following the use of the drug in the usual doses to prevent, diagnose, treat the disease or Changes in the physiological function of the body occur. Efforts to minimize ADR depend heavily on the efforts of medical professionals to reduce adverse drug reactions and to report events quickly. Undoubtedly, all members of health care providers can play an important role in achieving these goals through voluntary reporting.
If there are any side effects after consuming the products of Kharazmi Pharmaceutical Company, please fill out the form below to follow up

Subject
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Name *
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Age *
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Weight (Kg) *
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Gender
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Mobile *
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Address *
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Medication suspected of complication *
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Type of complication observed *
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Other medications used by the patient at the time of complication *
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Therapeutic measures performed *
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Complication onset date *
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How long did the complication last? *
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History of any drug side effects in the patient's past
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Patient history (allergy, hereditary disease, enzyme deficiency, current disease, addiction, etc.)
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Did the complication decrease after stopping the drug?
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Has the complication reappeared after repeated use of the drug?
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Final Status
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Did the drug complication lead to the patient's hospitalization?
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Paraclinical findings
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More Comments
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Specifications of the drug suspected of having a complication

Drug Name
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The shape and power of medicine
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Daily intake
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consumption instruction
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Ways to consume
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Date of use
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End date of use
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Batch No
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Other medications used by the patient at the time of complication

Drug Name
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The shape and power of medicine
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Daily intake
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consumption instruction
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Date of use
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End date of use
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manufacturing factory
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Batch No
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