Adverse Drug Reactions Reporting Form

Please, use this form if you wish to report suspected adverse drug reactions involving Sopharma medicinal products. The submitted information is of major importance for the detection of unknown adverse reactions to our medicinal products.
Please, do not hesitate to send a report even if you do not have all required data to fill out the form!
Your contact information will be used in the following cases/situations: if we need to ask you for further information; to confirm that we received the report; to inform you about the measures taken; for feedback.
We assure you that the reporter’s/patient’s personal data will be treated in compliance with the Personal Data Protection Act.
Address:
Sopharma AD, Quality Management and Regulatory Compliance Directorate, Drug Safety Department,
3 Kliment Ohridski Blvd., 1797 Sofia, Bulgaria
Telephone: +359 2 405 7413;
Fax: +359 2 974 3759;
E-mail: safety@sopharma.bg

Data about the person providing the information

Data about the patient

Suspected medication

Adverse drug reaction