Pharmacovigilance

Pharmacovigilance(PVG): Discovery, evaluation, understanding and prevention of adverse reactions (effects) or any other scientific research and activities that may be related to drugs

Adverse reactions: Harmful and unanticipated reactions to drugs that occur during prevention, diagnosis and treatment or improvement of physiological function using normal dosage in human body

Adverse Reaction/Adverse Event Report Form

Patient Information：

*Patient name

*Patient sex

Male

Female

Age

Weight

*Previous disease

Hospital

Department

Medication information:

*Name of suspected drug

*Name of manufacturer

*Manufacturing lot number

Name of combined drug

Name of combined drug manufacturer

Manufacturing lot number of combined drug

Process description:：

*Description of adverse reaction process

*Name of reporter

*Contact information of reporter

*Date of filling

*Whether agree a follow-up visit

Verification code

Submit

Remarks：

1.The suspected drug is the drug that the reporter believes it caused the adverse effects; and the combined drugs are the other drugs that the patient used in combination with the suspected drug.

2.At least one item shall be filled in the patient information.

3.Suggested reference format for description of adverse reaction process: The patient suffered from xx disease, used XX drug on xxxx, xx, and when and what adverse reactions occurred (related symptoms, signs and related inspections), when to take actions, when the adverse reactions were cured or improved (related symptoms, signs and related inspections)

4.Any medical institutions and patients can report here and also can contact us by the following ways in case of any suspected adverse reactions using any product of the subsidiaries of Biokin Pharmaceuticals Group (such as Sichuan Guorui Pharmaceutical Co., Ltd., Sichuan Biokin Pharmaceutical Co., Ltd., Chengdu Multispecific Antibody Pharmaceutical Co., Ltd.).
Tel：028-8532 1091
Email：pv@baili-pharm.com