[et_pb_section fb_built=”1″ _builder_version=”4.16″ custom_padding=”20px||||false|false” global_colors_info=”{}”][et_pb_row _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text admin_label=”titel – Onze producten” _builder_version=”4.19.4″ _dynamic_attributes=”content” global_colors_info=”{}”]@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF90aXRsZSIsInNldHRpbmdzIjp7ImJlZm9yZSI6IjxoMT4iLCJhZnRlciI6IjwvaDE+In19@[\/et_pb_text][et_pb_text _builder_version=”4.19.5″ global_colors_info=”{}”]<\/p>\n
All medications have side effects and must have a package leaflet. A side effect is an unwanted or medical incident in a patient receiving treatment with a medication or medical preparation that is not necessarily related to the treatment. The most common side effects are already known from clinical studies. We only discover certain side effects after many different people take a medication. Side effects may occur only after long-term use of the medication. And sometimes side effects occur when a medication is used in combination with other medications.<\/p>\n
Dietary supplements are covered by food legislation<\/a> because these are legally considered food. For dietary supplements, package leaflets are not required. Nevertheless, unwanted reactions may also occur.<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row use_custom_gutter=”on” gutter_width=”2″ _builder_version=”4.19.4″ custom_padding=”0px||||false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text admin_label=”subtitel” _builder_version=”4.19.5″ text_font=”Rubrik SemiBold|100|||||||” text_font_size=”26px” text_line_height=”1.72em” header_3_line_height=”1.2em” custom_padding=”|50px|||false|false” text_font_size_phone=”20px” text_font_size_last_edited=”off|tablet” header_3_font_size_tablet=”” header_3_font_size_phone=”20px” header_3_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n [\/et_pb_text][et_pb_text _builder_version=”4.19.5″ custom_margin=”||40px||false|false” global_colors_info=”{}”]<\/p>\n Qualiphar monitors medication safety by collecting and investigating all spontaneous reports from patients or care providers. We also have a statutory duty to collect and anonymise all details in an international database. All countries collect information on medication side effects in this international database. As a pharmaceutical company, we are regularly audited by the Federal Agency for Medicines and Health Products (FAMHP)<\/a>. This means we must always report your side effect.<\/p>\n [\/et_pb_text][et_pb_text admin_label=”subtitel” _builder_version=”4.19.5″ text_font=”Rubrik SemiBold|100|||||||” text_font_size=”26px” text_line_height=”1.72em” header_3_line_height=”1.2em” header_3_font_size_tablet=”” header_3_font_size_phone=”20px” header_3_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n [\/et_pb_text][et_pb_text admin_label=”Tekst” _builder_version=”4.19.5″ custom_margin=”||40px||false|false” global_colors_info=”{}”]<\/p>\n To help us process your information quickly and effectively, please submit as much relevant information as possible using the form below<\/a>. You should provide at least the following information:<\/p>\n [\/et_pb_text][et_pb_text admin_label=”subtitel” _builder_version=”4.19.5″ text_font=”Rubrik SemiBold|100|||||||” text_font_size=”26px” text_line_height=”1.72em” header_3_line_height=”1.2em” header_3_font_size_tablet=”” header_3_font_size_phone=”20px” header_3_font_size_last_edited=”on|phone” global_colors_info=”{}”]<\/p>\n [\/et_pb_text][et_pb_text _builder_version=”4.19.5″ custom_margin=”||40px||false|false” global_colors_info=”{}”]<\/p>\n If you have any questions about side effects of Qualiphar products, you are welcome to contact Qualiphar directly<\/a>. You may also report the side effect directly to the Federal Agency for Medicines and Health Products (FAMHP) by visiting www.eenbijwerkingmelden.be<\/a>.<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row disabled_on=”off|off|off” module_id=”contactform” _builder_version=”4.19.5″ _module_preset=”default” background_color=”#efefef” custom_padding=”|75px||75px|false|true” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.19.4″ _module_preset=”default” global_colors_info=”{}”][de_fb_form title=”Reporting a side effect” scrollto_form_after_submit=”off” redirect_after_success=”on” redirect_url_after_submission=”@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9saW5rX3VybF9wYWdlIiwic2V0dGluZ3MiOnsicG9zdF9pZCI6IjE3OTgyIn19@” failed_message=”Please fill out the form correctly%%message%%” use_custom_email=”off” custom_contact_email=”pharmacovigilance@qualiphar.com” from_name=”custom” custom_from_name=”Pharmacovigilance Qualiphar” from_email=”custom” custom_from_email=”pharmacovigilance@qualiphar.com” send_copy_to_sender=”on” sender_email_field=”4″ reply_from_name=”custom” reply_custom_from_name=”Pharmacovigilance Qualiphar” reply_from_email=”custom” reply_custom_from_email=”pharmacovigilance@qualiphar.com” reply_to_name=”Pharmacovigilance Qualiphar” reply_to_email=”pharmacovigilance@qualiphar.com” reply_email_title=”Melding bijwerking Qualiphar product” radio_checkbox_checked_color=”#000000″ multistep_enabled=”on” multistep_form_transition=”none” multistep_progress_bar_style=”lollipop” multistep_progress_bar_inactive_color=”#FFFFFF” multistep_show_progress_bar_percentage=”on” use_honeypot_captcha=”off” _builder_version=”4.19.5″ _dynamic_attributes=”redirect_url_after_submission” _module_preset=”default” form_field_background_color=”#FFFFFF” form_field_text_color=”#000000″ label_text_text_color=”#000000″ custom_button=”on” button_text_color=”#FFFFFF” button_bg_color=”#00574a” button_border_color=”RGBA(255,255,255,0)” button_border_radius=”5px” custom_previous_step_button=”on” previous_step_button_text_color=”#FFFFFF” previous_step_button_bg_color=”#53af32″ previous_step_button_border_color=”RGBA(255,255,255,0)” previous_step_button_border_radius=”5px” previous_step_button_icon=”D||divi||400″ previous_step_button_icon_color=”#FFFFFF” previous_step_button_icon_placement=”left” previous_step_button_on_hover=”off” custom_next_step_button=”on” next_step_button_text_color=”#FFFFFF” next_step_button_bg_color=”#53af32″ next_step_button_border_color=”RGBA(255,255,255,0)” next_step_button_border_radius=”5px” next_step_button_icon=”E||divi||400″ next_step_button_icon_color=”#FFFFFF” next_step_button_on_hover=”off” hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″][de_fb_form_field field_title=”Step one” field_id=”step-1″ field_type=”step” step_prev_text=”Preious” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”0″ form_class=”de_fb_form_0″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”Reporter contact details” field_id=”melder” field_type=”html_content” html_content_editor=”<\/p>\n ” _builder_version=”4.19.5″ _module_preset=”default” custom_margin=”40px||||false|false” global_colors_info=”{}” form_step=”1″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”1. First name” field_id=”1″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”2. Family name” field_id=”2_2″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”3. Phone” field_id=”3_2″ allowed_symbols=”numbers” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”4. Email” field_id=”4″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”5. I am the” field_id=”5″ field_type=”radio” radio_options=”%91{%22value%22:%22Patient%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22General practitioner%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Specialist%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Chemist%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Nurse%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Other%22,%22checked%22:0,%22dragID%22:4}%93″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”5-Andere” field_id=”5-andere” field_grid_column=”et_pb_column_2_3″ field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%225%22,%22condition%22:%22is%22,%22value%22:%22Other%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” custom_padding=”0px||||false|false” global_colors_info=”{}” form_step=”1″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”Step two” field_id=”step-2″ field_type=”step” step_prev_text=”Previous” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” prev_step_prev=”Preious” form_step=”1″ form_class=”de_fb_form_0″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”Patient details” field_id=”pati\u00ebnt” field_type=”html_content” html_content_editor=”<\/p>\n ” _builder_version=”4.19.5″ _module_preset=”default” custom_margin=”40px||||false|false” global_colors_info=”{}” form_step=”2″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”6. Initials” field_id=”6″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”2″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”7. Gender” field_id=”7″ field_type=”radio” radio_options=”%91{%22value%22:%22M%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22F%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Other%22,%22checked%22:0,%22dragID%22:1}%93″ field_grid_column=”et_pb_column_2_3″ field_label_position=”top” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”2″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”7 Andere” field_id=”7-andere” field_grid_column=”et_pb_column_2_3″ field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%227%22,%22condition%22:%22is%22,%22value%22:%22Other%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” custom_padding=”0px||||false|false” global_colors_info=”{}” form_step=”2″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”8. Age” field_id=”8″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”2″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”9. Was the medication prescribed?” field_id=”9″ field_type=”radio” radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Other%22,%22checked%22:0,%22dragID%22:1}%93″ field_grid_column=”et_pb_column_2_3″ field_label_position=”top” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”2″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”9 Andere” field_id=”9-andere” field_grid_column=”et_pb_column_2_3″ field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Other%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” custom_padding=”0px||||false|false” global_colors_info=”{}” form_step=”2″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”Step three” field_id=”step-3″ field_type=”step” step_prev_text=”Previous” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Ja%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” prev_step_prev=”Previous” form_step=”2″ form_class=”de_fb_form_0″ current_step=”1″ sticky_enabled=”0″][\/de_fb_form_field][de_fb_form_field field_title=”Gegevens voorschrijver” field_id=”voorschrijver” field_type=”html_content” html_content_editor=”<\/p>\n ” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” custom_margin=”40px||||false|false” hover_enabled=”0″ global_colors_info=”{}” form_step=”3″ current_step=”1″ sticky_enabled=”0″][\/de_fb_form_field][de_fb_form_field field_title=”Go on” field_id=”go_on” field_type=”html_content” html_content_editor=”<\/p>\n Please, press %22next%22<\/strong><\/p>\n ” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22No%22},{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Other%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” custom_margin=”40px||||false|false” hover_enabled=”0″ global_colors_info=”{}” form_step=”3″ current_step=”1″ sticky_enabled=”0″][\/de_fb_form_field][de_fb_form_field field_title=”10. Prescriber details” field_id=”10″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” form_step=”3″ current_step=”1″ sticky_enabled=”0″][\/de_fb_form_field][de_fb_form_field field_title=”11. Institution name” field_id=”11″ field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” form_step=”3″ current_step=”1″ sticky_enabled=”0″][\/de_fb_form_field][de_fb_form_field field_title=”12. Profession \/ specialism” field_id=”12″ field_type=”radio” radio_options=”%91{%22value%22:%22General practitioner%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Specialist%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Other%22,%22checked%22:0,%22dragID%22:1}%93″ field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Voer uw antwoord in” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” form_step=”3″ current_step=”1″ sticky_enabled=”0″][\/de_fb_form_field][de_fb_form_field field_title=”12 Andere” field_id=”12-andere” field_grid_column=”et_pb_column_2_3″ field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%2212%22,%22condition%22:%22is%22,%22value%22:%22Other%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” custom_padding=”0px||||false|false” global_colors_info=”{}” form_step=”3″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”13. Phone” field_id=”13″ allowed_symbols=”numbers” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” form_step=”3″ current_step=”1″ sticky_enabled=”0″][\/de_fb_form_field][de_fb_form_field field_title=”14. Email” field_id=”14″ field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” form_step=”3″ current_step=”1″ sticky_enabled=”0″][\/de_fb_form_field][de_fb_form_field field_title=”15. I consent to Qualiphar contacting my prescriber about this side effect.” field_id=”15″ field_type=”radio” radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0}%93″ field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” form_step=”3″ current_step=”1″ sticky_enabled=”0″][\/de_fb_form_field][de_fb_form_field field_title=”Step four” field_id=”step-4″ field_type=”step” step_prev_text=”Previous” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” prev_step_prev=”Previous” form_step=”3″ form_class=”de_fb_form_0″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”Medication \/ Product” field_id=”geneesmiddel” field_type=”html_content” html_content_editor=”<\/p>\n ” _builder_version=”4.19.5″ _module_preset=”default” custom_margin=”40px||||false|false” global_colors_info=”{}” form_step=”4″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”16. Medication \/ Product” field_id=”16″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”4″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”17. Pharmaceutical form” field_id=”17″ field_type=”radio” radio_options=”%91{%22value%22:%22Tablet%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Liquid form%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Ointment%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Powder%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Other%22,%22checked%22:0,%22dragID%22:3}%93″ field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”4″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”17 Andere” field_id=”17-andere” field_grid_column=”et_pb_column_2_3″ field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%2217%22,%22condition%22:%22is%22,%22value%22:%22Other%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” custom_padding=”0px||||false|false” global_colors_info=”{}” form_step=”4″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”18. Start date of medication use” field_id=”18″ field_type=”datepicker” date_time_picker_lang=”nl” date_format=”dd-mm-yy” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”4″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”19. Dosage” field_id=”19″ field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” description_text=”on” description_text_text=”What dose of the Qualiphar medication was used?” _builder_version=”4.19.5″ _module_preset=”default” field_description_line_height=”2em” global_colors_info=”{}” form_step=”4″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”20. Batch number” field_id=”20″ field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” description_text=”on” description_text_text=”See packaging” _builder_version=”4.19.5″ _module_preset=”default” field_description_line_height=”2em” global_colors_info=”{}” form_step=”4″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”21. For what indication was the medication used?” field_id=”21″ field_type=”text” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” field_description_text_color=”#494949″ field_description_line_height=”2em” global_colors_info=”{}” form_step=”4″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”Step five” field_id=”step-5″ field_type=”step” step_prev_text=”Previous” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” prev_step_prev=”Previous” form_step=”4″ form_class=”de_fb_form_0″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”Side effect” field_id=”bijwerking” field_type=”html_content” html_content_editor=”<\/p>\n ” _builder_version=”4.19.5″ _module_preset=”default” custom_margin=”40px||||false|false” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”22. This concerns a:” field_id=”22″ field_type=”radio” radio_options=”%91{%22value%22:%22Side effect%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Transmission of infection%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Exposure during pregnancy or breastfeeding (also without side effects)%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Incorrect use%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Abuse and\/or dependency%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Medication error%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Overdosis%22,%22checked%22:0,%22dragID%22:5},{%22value%22:%22Occupational exposure%22,%22checked%22:0,%22dragID%22:6},{%22value%22:%22Lack of efficacy%22,%22checked%22:0,%22dragID%22:7},{%22value%22:%22Other%22,%22checked%22:0,%22dragID%22:8}%93″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”22 Andere” field_id=”22-andere” field_grid_column=”et_pb_column_2_3″ field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%2222%22,%22condition%22:%22is%22,%22value%22:%22Other%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” custom_padding=”0px||||false|false” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”23. Side effect description” field_id=”23″ field_type=”text” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” field_description_text_color=”#494949″ field_description_line_height=”2em” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”24. Did the side effect result in any of the following serious situations? ” field_id=”24″ field_type=”radio” radio_options=”%91{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Hospitalisation (or prolonging the stay)%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Permanent disability or invalidity%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Life-threatening%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Congenital abnormalities%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Other serious abnormalities?%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Other%22,%22checked%22:0,%22dragID%22:5}%93″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”24 Andere” field_id=”24-andere” field_grid_column=”et_pb_column_2_3″ field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%2224%22,%22condition%22:%22is%22,%22value%22:%22Other%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” custom_padding=”0px||||false|false” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”25. Was the medication” field_id=”25″ field_type=”radio” radio_options=”%91{%22value%22:%22Discontinued%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Temporarily suspended%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Dose reduced%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Dose increased%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Unchanged%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Unknown%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Other%22,%22checked%22:0,%22dragID%22:5}%93″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”25 Andere” field_id=”25-andere” field_grid_column=”et_pb_column_2_3″ field_placeholder=”Enter your answer” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%2225%22,%22condition%22:%22is%22,%22value%22:%22Other%22}%93″ _builder_version=”4.19.5″ _module_preset=”default” custom_padding=”0px||||false|false” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”26. Was treatment prescribed?” field_id=”26″ field_type=”text” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” field_description_text_color=”#494949″ field_description_line_height=”2em” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”27. Additional information about the side effect” field_id=”27″ field_type=”text” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” field_placeholder=”Enter your answer” _builder_version=”4.19.5″ _module_preset=”default” field_description_text_color=”#494949″ field_description_line_height=”2em” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”28. Question” field_id=”28″ field_type=”radio” radio_options=”%91{%22value%22:%22Qualiphar may contact me about this side effect%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22I do not want Qualiphar to contact me about this side effect.%22,%22checked%22:0,%22dragID%22:0}%93″ required_mark=”on” required_message=”Enter your answer” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”Privacy Statement” field_id=”privacy” field_type=”html_content” html_content_editor=”<\/p>\n The information requested on this page can help us better identify medication-related risks. This is important for monitoring the quality and safety of our products. The details you enter contain personal information. This information will be kept strictly confidential. Your personal details will be placed in a database and forwarded anonymously to the authorities that must be informed about all possible side effects of medications. Except for the government, your data will not be provided to third parties and will not be used for commercial purposes.<\/p>\n (i) Providing the patient\u2019s gender and date of birth allows us to check whether we may have also received the same notification from their doctor, dispensing chemist, etc.<\/p>\n (ii) To process a side effect, we need information about the person making the report (the reporter). We need this information to answer any question you asked.<\/p>\n ” _builder_version=”4.19.5″ _module_preset=”default” custom_margin=”40px||||false|false” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][de_fb_form_field field_title=”Privacy akkoord” field_id=”30″ field_type=”checkbox” checkbox_options=”%91{%22value%22:%22I agree with the privacy statement%22,%22checked%22:0,%22dragID%22:-1}%93″ required_mark=”on” required_message=”Required field” radio_checkbox_checked_color=”#000000″ _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][\/de_fb_form_field][\/de_fb_form][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":" All medications have side effects and must have a package leaflet. A side effect is an unwanted or medical incident in a patient receiving treatment with a medication or medical preparation that is not necessarily related to the treatment. The most common side effects are already known from clinical studies. We only discover certain side […]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-18462","page","type-page","status-publish","hentry"],"yoast_head":"\nThe importance of reporting a side effect<\/h3>\n
How do I report a side effect?<\/h3>\n
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What happens to your report?<\/h3>\n
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Reporter contact details<\/h3>\n
Patient details<\/h3>\n
Gegegevens voorschrijver<\/h3>\n
Medication \/ Product<\/h3>\n
Side effect<\/h3>\n
Privacy statement<\/h3>\n