{"id":18481,"date":"2023-02-27T14:46:58","date_gmt":"2023-02-27T13:46:58","guid":{"rendered":"https:\/\/qualiphar.be\/?page_id=18481"},"modified":"2023-02-28T08:59:18","modified_gmt":"2023-02-28T07:59:18","slug":"signaler-un-effet-indesirable","status":"publish","type":"page","link":"https:\/\/qualiphar.be\/fr\/signaler-un-effet-indesirable\/","title":{"rendered":"Signaler un effet ind\u00e9sirable"},"content":{"rendered":"<p>[et_pb_section fb_built=\u00a0\u00bb1&Prime; _builder_version=\u00a0\u00bb4.16&Prime; custom_padding=\u00a0\u00bb20px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_row _builder_version=\u00a0\u00bb4.16&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_column type=\u00a0\u00bb4_4&Prime; _builder_version=\u00a0\u00bb4.16&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_text admin_label=\u00a0\u00bbtitel &#8211; Onze producten\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _dynamic_attributes=\u00a0\u00bbcontent\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF90aXRsZSIsInNldHRpbmdzIjp7ImJlZm9yZSI6IjxoMT4iLCJhZnRlciI6IjwvaDE+In19@[\/et_pb_text][et_pb_text _builder_version=\u00a0\u00bb4.19.5&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]<\/p>\n<p>Tous les m\u00e9dicaments ont des effets secondaires et sont obligatoirement accompagn\u00e9s d\u2019une notice. Un effet secondaire est un \u00e9v\u00e9nement ind\u00e9sirable ou m\u00e9dical chez un(e) patient(e) qui re\u00e7oit un traitement par un m\u00e9dicament ou un dispositif m\u00e9dical et n\u2019est pas n\u00e9cessairement li\u00e9 \u00e0 ce traitement. Les effets secondaires les plus fr\u00e9quents sont d\u00e9j\u00e0 connus gr\u00e2ce aux \u00e9tudes cliniques. Certains effets secondaires sont seulement d\u00e9couverts lorsque de nombreuses personnes diff\u00e9rentes utilisent un m\u00e9dicament. Il est \u00e9galement possible que les effets secondaires n\u2019apparaissent qu\u2019apr\u00e8s une utilisation prolong\u00e9e du m\u00e9dicament et, parfois, des effets secondaires se manifestent parce qu\u2019un m\u00e9dicament est utilis\u00e9 en association avec d\u2019autres m\u00e9dicaments.<\/p>\n<p>Les compl\u00e9ments alimentaires rel\u00e8vent de <a href=\"https:\/\/www.health.belgium.be\/fr\/alimentation\/politique-alimentaire\/cadre-legislatif-et-normatif\/loi-alimentaire\" target=\"_blank\" rel=\"noopener\">la l\u00e9gislation des denr\u00e9es alimentaires<\/a>, car, d\u2019un point de vue l\u00e9gal, ils sont consid\u00e9r\u00e9s comme des aliments. Les notices ne sont pas obligatoires pour les compl\u00e9ments alimentaires. Cependant, des r\u00e9actions ind\u00e9sirables peuvent aussi survenir.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row use_custom_gutter=\u00a0\u00bbon\u00a0\u00bb gutter_width=\u00a0\u00bb2&Prime; _builder_version=\u00a0\u00bb4.19.4&Prime; custom_padding=\u00a0\u00bb0px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_column type=\u00a0\u00bb4_4&Prime; _builder_version=\u00a0\u00bb4.16&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_text admin_label=\u00a0\u00bbsubtitel\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; text_font=\u00a0\u00bbRubrik SemiBold|100|||||||\u00a0\u00bb text_font_size=\u00a0\u00bb26px\u00a0\u00bb text_line_height=\u00a0\u00bb1.72em\u00a0\u00bb header_3_line_height=\u00a0\u00bb1.2em\u00a0\u00bb custom_padding=\u00a0\u00bb|50px|||false|false\u00a0\u00bb text_font_size_phone=\u00a0\u00bb20px\u00a0\u00bb text_font_size_last_edited=\u00a0\u00bboff|tablet\u00a0\u00bb header_3_font_size_tablet=\u00a0\u00bb\u00a0\u00bb header_3_font_size_phone=\u00a0\u00bb20px\u00a0\u00bb header_3_font_size_last_edited=\u00a0\u00bbon|phone\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]<\/p>\n<h3>L\u2019importance de signaler un effet ind\u00e9sirable<\/h3>\n<p>[\/et_pb_text][et_pb_text _builder_version=\u00a0\u00bb4.19.5&Prime; custom_margin=\u00a0\u00bb||40px||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]<\/p>\n<p>Qualiphar surveille l\u2019innocuit\u00e9 des m\u00e9dicaments en recueillant et en examinant tous les signalements spontan\u00e9s de patient(e)s ou de prestataires de soins de sant\u00e9. Nous avons \u00e9galement l\u2019obligation l\u00e9gale de rassembler tous ces t\u00e9moignages de mani\u00e8re anonymis\u00e9e dans une base de donn\u00e9es internationale. Dans cette base de donn\u00e9es internationale, tous les pays r\u00e9unissent les informations sur les effets secondaires des m\u00e9dicaments. En qualit\u00e9 d\u2019entreprise pharmaceutique, nous sommes soumis \u00e0 des contr\u00f4les r\u00e9guliers par <a href=\"https:\/\/www.afmps.be\/fr\/notifier_un_effet_indesirable_en_tant_que_patient\" target=\"_blank\" rel=\"noopener\">l\u2019Agence f\u00e9d\u00e9rale des m\u00e9dicaments et des produits de sant\u00e9 (AFMPS)<\/a>. C\u2019est pourquoi il est important de toujours signaler tout effet secondaire.<\/p>\n<p>[\/et_pb_text][et_pb_text admin_label=\u00a0\u00bbsubtitel\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; text_font=\u00a0\u00bbRubrik SemiBold|100|||||||\u00a0\u00bb text_font_size=\u00a0\u00bb26px\u00a0\u00bb text_line_height=\u00a0\u00bb1.72em\u00a0\u00bb header_3_line_height=\u00a0\u00bb1.2em\u00a0\u00bb header_3_font_size_tablet=\u00a0\u00bb\u00a0\u00bb header_3_font_size_phone=\u00a0\u00bb20px\u00a0\u00bb header_3_font_size_last_edited=\u00a0\u00bbon|phone\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]<\/p>\n<h3>Comment signaler un effet ind\u00e9sirable ?<\/h3>\n<p>[\/et_pb_text][et_pb_text admin_label=\u00a0\u00bbTekst\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; custom_margin=\u00a0\u00bb||40px||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]<\/p>\n<p>Pour nous aider \u00e0 traiter rapidement et efficacement vos informations, nous vous demandons de fournir le plus d\u2019informations pertinentes possible au moyen du <a href=\"#contactform\">formulaire ci-dessous<\/a>. Vous devez indiquer au moins les informations suivantes :<\/p>\n<ul>\n<li>Les informations de contact de la personne \u00e9mettant la notification.<br \/>Les initiales de la personne ayant subi le potentiel effet secondaire et\/ou d\u2019autres informations personnelles, telles que le sexe, la date de naissance.<\/li>\n<li>Le nom du m\u00e9dicament ou du produit Qualiphar.<\/li>\n<li>Une description du potentiel effet secondaire, par exemple les sympt\u00f4mes, la date de la premi\u00e8re manifestation du potentiel effet secondaire et l\u2019issue du potentiel effet secondaire.<\/li>\n<\/ul>\n<p>[\/et_pb_text][et_pb_text admin_label=\u00a0\u00bbsubtitel\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; text_font=\u00a0\u00bbRubrik SemiBold|100|||||||\u00a0\u00bb text_font_size=\u00a0\u00bb26px\u00a0\u00bb text_line_height=\u00a0\u00bb1.72em\u00a0\u00bb header_3_line_height=\u00a0\u00bb1.2em\u00a0\u00bb header_3_font_size_tablet=\u00a0\u00bb\u00a0\u00bb header_3_font_size_phone=\u00a0\u00bb20px\u00a0\u00bb header_3_font_size_last_edited=\u00a0\u00bbon|phone\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]<\/p>\n<h3>Qu\u2019advient-il de votre notification ?<\/h3>\n<p>[\/et_pb_text][et_pb_text _builder_version=\u00a0\u00bb4.19.5&Prime; custom_margin=\u00a0\u00bb||40px||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]<\/p>\n<ol>\n<li>Nos coll\u00e8gues du service de pharmacovigilance collectent, enregistrent et analysent chaque notification individuelle.<\/li>\n<li>Lorsqu\u2019un effet secondaire est signal\u00e9, il est possible que Qualiphar recueille certaines donn\u00e9es personnelles. Vous trouverez de plus amples informations \u00e0 ce sujet dans <a href=\"https:\/\/qualiphar.be\/fr\/politique-de-protection-de-la-vie-privee\/\">la politique de protection de la vie priv\u00e9e<\/a>. <\/li>\n<li>Chaque effet secondaire est enregistr\u00e9 dans la base de donn\u00e9es internationale, o\u00f9 il est \u00e9galement examin\u00e9 par les autorit\u00e9s comp\u00e9tentes. Des sp\u00e9cialistes \u00e9valuent ces effets secondaires afin de pouvoir prendre des mesures si n\u00e9cessaire, par exemple en adaptant la notice ou en avertissant les prestataires de soins de sant\u00e9.<\/li>\n<\/ol>\n<p>Si vous avez des questions au sujet des effets secondaires des produits Qualiphar, vous pouvez \u00e9videmment aussi <a href=\"https:\/\/qualiphar.be\/fr\/contact\/\">contacter Qualiphar<\/a> directement. Vous pouvez aussi signaler l\u2019effet secondaire directement \u00e0 l\u2019Agence f\u00e9d\u00e9rale des m\u00e9dicaments et des produits de sant\u00e9 (AFMPS) en vous rendant sur le site <a href=\"https:\/\/www.afmps.be\/fr\/effet_indesirable\" target=\"_blank\" rel=\"noopener\">www.notifieruneffetindesirable.be<\/a>.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row disabled_on=\u00a0\u00bboff|off|off\u00a0\u00bb module_id=\u00a0\u00bbcontactform\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb background_color=\u00a0\u00bb#efefef\u00a0\u00bb custom_padding=\u00a0\u00bb|75px||75px|false|true\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_column type=\u00a0\u00bb4_4&Prime; _builder_version=\u00a0\u00bb4.19.4&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][de_fb_form title=\u00a0\u00bbSignaler un effet ind\u00e9sirable\u00a0\u00bb submit_button_text=\u00a0\u00bbEnvoyer\u00a0\u00bb scrollto_form_after_submit=\u00a0\u00bboff\u00a0\u00bb redirect_after_success=\u00a0\u00bbon\u00a0\u00bb redirect_url_after_submission=\u00a0\u00bb@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9saW5rX3VybF9wYWdlIiwic2V0dGluZ3MiOnsicG9zdF9pZCI6IjE3OTgyIn19@\u00a0\u00bb failed_message=\u00a0\u00bbVeuillez remplir le formulaire correctement%%message%%\u00a0\u00bb use_custom_email=\u00a0\u00bboff\u00a0\u00bb custom_contact_email=\u00a0\u00bbpharmacovigilance@qualiphar.com\u00a0\u00bb from_name=\u00a0\u00bbcustom\u00a0\u00bb custom_from_name=\u00a0\u00bbPharmacovigilance Qualiphar\u00a0\u00bb from_email=\u00a0\u00bbcustom\u00a0\u00bb custom_from_email=\u00a0\u00bbpharmacovigilance@qualiphar.com\u00a0\u00bb send_copy_to_sender=\u00a0\u00bbon\u00a0\u00bb sender_email_field=\u00a0\u00bb4&Prime; 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next_step_button_border_color=\u00a0\u00bbRGBA(255,255,255,0)\u00a0\u00bb next_step_button_border_radius=\u00a0\u00bb5px\u00a0\u00bb next_step_button_icon=\u00a0\u00bb&#x45;||divi||400&Prime; next_step_button_icon_color=\u00a0\u00bb#FFFFFF\u00a0\u00bb next_step_button_on_hover=\u00a0\u00bboff\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb sticky_enabled=\u00a0\u00bb0&Prime;][de_fb_form_field field_title=\u00a0\u00bbStep one\u00a0\u00bb field_id=\u00a0\u00bbstep-1&Prime; field_type=\u00a0\u00bbstep\u00a0\u00bb step_prev_text=\u00a0\u00bbPr\u00e9c\u00e9dent\u00a0\u00bb step_next_text=\u00a0\u00bbSuivant\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb0&Prime; form_class=\u00a0\u00bbde_fb_form_0&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbContactgegevens melder\u00a0\u00bb field_id=\u00a0\u00bbmelder\u00a0\u00bb field_type=\u00a0\u00bbhtml_content\u00a0\u00bb html_content_editor=\u00a0\u00bb<\/p>\n<h3>Coordonn\u00e9es de la personne \u00e9mettant la notification<\/h3>\n<p>\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_margin=\u00a0\u00bb40px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb1&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb1. 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T\u00e9l\u00e9phone\u00a0\u00bb field_id=\u00a0\u00bb3_2&Prime; allowed_symbols=\u00a0\u00bbnumbers\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb1&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb4. E-mail\u00a0\u00bb field_id=\u00a0\u00bb4&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb1&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb5. Je suis\u00a0\u00bb field_id=\u00a0\u00bb5&Prime; field_type=\u00a0\u00bbradio\u00a0\u00bb radio_options=\u00a0\u00bb%91{%22value%22:%22Patient(e)%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22M\u00e9decin g\u00e9n\u00e9raliste%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22M\u00e9decin sp\u00e9cialiste%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Pharmacien(ne)%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Infirmier\/infirmi\u00e8re%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Autre%22,%22checked%22:0,%22dragID%22:4}%93&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb1&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb5-Andere\u00a0\u00bb field_id=\u00a0\u00bb5-andere\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%225%22,%22condition%22:%22is%22,%22value%22:%22Autre%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_padding=\u00a0\u00bb0px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb1&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbStep two\u00a0\u00bb field_id=\u00a0\u00bbstep-2&Prime; field_type=\u00a0\u00bbstep\u00a0\u00bb step_prev_text=\u00a0\u00bbPr\u00e9c\u00e9dent\u00a0\u00bb step_next_text=\u00a0\u00bbSuivant\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb prev_step_next=\u00a0\u00bbSuivant\u00a0\u00bb prev_step_prev=\u00a0\u00bbPr\u00e9c\u00e9dent\u00a0\u00bb form_step=\u00a0\u00bb1&Prime; form_class=\u00a0\u00bbde_fb_form_0&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbGegevens pati\u00ebnt\u00a0\u00bb field_id=\u00a0\u00bbpati\u00ebnt\u00a0\u00bb field_type=\u00a0\u00bbhtml_content\u00a0\u00bb html_content_editor=\u00a0\u00bb<\/p>\n<h3>Informations sur le\/la patient(e)<\/h3>\n<p>\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_margin=\u00a0\u00bb40px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb2&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb6. Initiales\u00a0\u00bb field_id=\u00a0\u00bb6&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb2&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb7. Sexe\u00a0\u00bb field_id=\u00a0\u00bb7&Prime; field_type=\u00a0\u00bbradio\u00a0\u00bb radio_options=\u00a0\u00bb%91{%22value%22:%22H%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22F%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Autre%22,%22checked%22:0,%22dragID%22:1}%93&Prime; field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb2&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb7 Andere\u00a0\u00bb field_id=\u00a0\u00bb7-andere\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%227%22,%22condition%22:%22is%22,%22value%22:%22Autre%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_padding=\u00a0\u00bb0px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb2&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb8. \u00c2ge\u00a0\u00bb field_id=\u00a0\u00bb8&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb2&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb9. Le m\u00e9dicament a-t-il \u00e9t\u00e9 prescrit ?\u00a0\u00bb field_id=\u00a0\u00bb9&Prime; field_type=\u00a0\u00bbradio\u00a0\u00bb radio_options=\u00a0\u00bb%91{%22value%22:%22Oui%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Non%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Autre%22,%22checked%22:0,%22dragID%22:1}%93&Prime; field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb2&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb9 Andere\u00a0\u00bb field_id=\u00a0\u00bb9-andere\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Autre%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_padding=\u00a0\u00bb0px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb2&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbStep three\u00a0\u00bb field_id=\u00a0\u00bbstep-3&Prime; field_type=\u00a0\u00bbstep\u00a0\u00bb step_prev_text=\u00a0\u00bbPr\u00e9c\u00e9dent\u00a0\u00bb step_next_text=\u00a0\u00bbSuivant\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Ja%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb prev_step_next=\u00a0\u00bbSuivant\u00a0\u00bb prev_step_prev=\u00a0\u00bbPr\u00e9c\u00e9dent\u00a0\u00bb form_step=\u00a0\u00bb2&Prime; form_class=\u00a0\u00bbde_fb_form_0&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbGegevens voorschrijver\u00a0\u00bb field_id=\u00a0\u00bbvoorschrijver\u00a0\u00bb field_type=\u00a0\u00bbhtml_content\u00a0\u00bb html_content_editor=\u00a0\u00bb<\/p>\n<h3>Informations sur la personne prescriptrice<\/h3>\n<p>\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Oui%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_margin=\u00a0\u00bb40px||||false|false\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb3&Prime; current_step=\u00a0\u00bb1&Prime; sticky_enabled=\u00a0\u00bb0&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbGa verder\u00a0\u00bb field_id=\u00a0\u00bbga_verder\u00a0\u00bb field_type=\u00a0\u00bbhtml_content\u00a0\u00bb html_content_editor=\u00a0\u00bb<\/p>\n<p><strong>Veuillez cliquer sur le bouton %22suivant%22.<\/strong><\/p>\n<p>\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Non%22},{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Autre%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_margin=\u00a0\u00bb40px||||false|false\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb3&Prime; current_step=\u00a0\u00bb1&Prime; sticky_enabled=\u00a0\u00bb0&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb10. Nom de la personne prescriptrice\u00a0\u00bb field_id=\u00a0\u00bb10&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Oui%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb3&Prime; current_step=\u00a0\u00bb1&Prime; sticky_enabled=\u00a0\u00bb0&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb11. Nom de l\u2019\u00e9tablissement\u00a0\u00bb field_id=\u00a0\u00bb11&Prime; field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Oui%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb3&Prime; current_step=\u00a0\u00bb1&Prime; sticky_enabled=\u00a0\u00bb0&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb12. Profession\/sp\u00e9cialit\u00e9\u00a0\u00bb field_id=\u00a0\u00bb12&Prime; field_type=\u00a0\u00bbradio\u00a0\u00bb radio_options=\u00a0\u00bb%91{%22value%22:%22M\u00e9decin g\u00e9n\u00e9raliste%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22M\u00e9decin sp\u00e9cialiste%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Autre%22,%22checked%22:0,%22dragID%22:1}%93&Prime; field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbVoer uw antwoord in\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Oui%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb3&Prime; current_step=\u00a0\u00bb1&Prime; sticky_enabled=\u00a0\u00bb0&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb12 Andere\u00a0\u00bb field_id=\u00a0\u00bb12-andere\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%2212%22,%22condition%22:%22is%22,%22value%22:%22Autre%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_padding=\u00a0\u00bb0px||||false|false\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb3&Prime; current_step=\u00a0\u00bb1&Prime; sticky_enabled=\u00a0\u00bb0&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb13. T\u00e9l\u00e9phone\u00a0\u00bb field_id=\u00a0\u00bb13&Prime; allowed_symbols=\u00a0\u00bbnumbers\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Oui%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb3&Prime; current_step=\u00a0\u00bb1&Prime; sticky_enabled=\u00a0\u00bb0&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb14. E-mail\u00a0\u00bb field_id=\u00a0\u00bb14&Prime; field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Oui%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb3&Prime; current_step=\u00a0\u00bb1&Prime; sticky_enabled=\u00a0\u00bb0&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb15. J\u2019autorise Qualiphar \u00e0 prendre contact avec la personne prescriptrice au sujet de cet effet secondaire\u00a0\u00bb field_id=\u00a0\u00bb15&Prime; field_type=\u00a0\u00bbradio\u00a0\u00bb radio_options=\u00a0\u00bb%91{%22value%22:%22Oui%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Non%22,%22checked%22:0,%22dragID%22:0}%93&Prime; field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Oui%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb hover_enabled=\u00a0\u00bb0&Prime; global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb3&Prime; current_step=\u00a0\u00bb1&Prime; sticky_enabled=\u00a0\u00bb0&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbStep four\u00a0\u00bb field_id=\u00a0\u00bbstep-4&Prime; field_type=\u00a0\u00bbstep\u00a0\u00bb step_prev_text=\u00a0\u00bbPr\u00e9c\u00e9dent\u00a0\u00bb step_next_text=\u00a0\u00bbSuivant\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb prev_step_next=\u00a0\u00bbSuivant\u00a0\u00bb prev_step_prev=\u00a0\u00bbPr\u00e9c\u00e9dent\u00a0\u00bb form_step=\u00a0\u00bb3&Prime; form_class=\u00a0\u00bbde_fb_form_0&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbGeneesmiddel \/ Product\u00a0\u00bb field_id=\u00a0\u00bbgeneesmiddel\u00a0\u00bb field_type=\u00a0\u00bbhtml_content\u00a0\u00bb html_content_editor=\u00a0\u00bb<\/p>\n<h3>M\u00e9dicament\/Produit<\/h3>\n<p>\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_margin=\u00a0\u00bb40px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb4&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb16. Nom du m\u00e9dicament\/produit \u00a0\u00bb field_id=\u00a0\u00bb16&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb4&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb17. Forme pharmaceutique\u00a0\u00bb field_id=\u00a0\u00bb17&Prime; field_type=\u00a0\u00bbradio\u00a0\u00bb radio_options=\u00a0\u00bb%91{%22value%22:%22Comprim\u00e9%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Forme liquide%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Pommade%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Poudre%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Autre%22,%22checked%22:0,%22dragID%22:3}%93&Prime; field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbVoer uw antwoord in\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb4&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb17 Andere\u00a0\u00bb field_id=\u00a0\u00bb17-andere\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%2217%22,%22condition%22:%22is%22,%22value%22:%22Autre%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_padding=\u00a0\u00bb0px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb4&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb18. Date de d\u00e9but d\u2019utilisation du m\u00e9dicament\u00a0\u00bb field_id=\u00a0\u00bb18&Prime; field_type=\u00a0\u00bbdatepicker\u00a0\u00bb date_time_picker_lang=\u00a0\u00bbnl\u00a0\u00bb date_format=\u00a0\u00bbdd-mm-yy\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb4&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb19. Dosage\u00a0\u00bb field_id=\u00a0\u00bb19&Prime; field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb description_text=\u00a0\u00bbon\u00a0\u00bb description_text_text=\u00a0\u00bbQuelle dose du m\u00e9dicament Qualiphar a \u00e9t\u00e9 utilis\u00e9e ?\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb field_description_line_height=\u00a0\u00bb2em\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb4&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb20. Num\u00e9ro de lot\u00a0\u00bb field_id=\u00a0\u00bb20&Prime; field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb description_text=\u00a0\u00bbon\u00a0\u00bb description_text_text=\u00a0\u00bbVoir emballage\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb field_description_line_height=\u00a0\u00bb2em\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb4&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb21. Pour quelle indication le m\u00e9dicament a-t-il \u00e9t\u00e9 utilis\u00e9 ?\u00a0\u00bb field_id=\u00a0\u00bb21&Prime; field_type=\u00a0\u00bbtext\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb field_description_text_color=\u00a0\u00bb#494949&Prime; field_description_line_height=\u00a0\u00bb2em\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb4&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbStep five\u00a0\u00bb field_id=\u00a0\u00bbstep-5&Prime; field_type=\u00a0\u00bbstep\u00a0\u00bb step_prev_text=\u00a0\u00bbPr\u00e9c\u00e9dent\u00a0\u00bb step_next_text=\u00a0\u00bbSuivant\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb prev_step_next=\u00a0\u00bbSuivant\u00a0\u00bb prev_step_prev=\u00a0\u00bbPr\u00e9c\u00e9dent\u00a0\u00bb form_step=\u00a0\u00bb4&Prime; form_class=\u00a0\u00bbde_fb_form_0&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbBijwerking\u00a0\u00bb field_id=\u00a0\u00bbbijwerking\u00a0\u00bb field_type=\u00a0\u00bbhtml_content\u00a0\u00bb html_content_editor=\u00a0\u00bb<\/p>\n<h3>Effet secondaire<\/h3>\n<p>\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_margin=\u00a0\u00bb40px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb22. Ceci concerne :\u00a0\u00bb field_id=\u00a0\u00bb22&Prime; field_type=\u00a0\u00bbradio\u00a0\u00bb radio_options=\u00a0\u00bb%91{%22value%22:%22Un effet secondaire%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22La transmission d\u2019une infection%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Une exposition pendant la grossesse ou l\u2019allaitement (\u00e9galement sans effet secondaire)%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Une mauvaise utilisation%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Un abus et\/ou une d\u00e9pendance%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Une erreur de m\u00e9dication%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Un surdosage%22,%22checked%22:0,%22dragID%22:5},{%22value%22:%22 Une exposition professionnelle%22,%22checked%22:0,%22dragID%22:6},{%22value%22:%22Un manque d\u2019efficacit\u00e9%22,%22checked%22:0,%22dragID%22:7},{%22value%22:%22Autre%22,%22checked%22:0,%22dragID%22:8}%93&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb22 Andere\u00a0\u00bb field_id=\u00a0\u00bb22-andere\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_placeholder=\u00a0\u00bbVoer uw antwoord in\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%2222%22,%22condition%22:%22is%22,%22value%22:%22Autre%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_padding=\u00a0\u00bb0px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb23. Description de l\u2019effet secondaire\u00a0\u00bb field_id=\u00a0\u00bb23&Prime; field_type=\u00a0\u00bbtext\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb field_description_text_color=\u00a0\u00bb#494949&Prime; field_description_line_height=\u00a0\u00bb2em\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb24. L\u2019effet secondaire a-t-il entra\u00een\u00e9 l\u2019une des situations graves suivantes ? \u00a0\u00bb field_id=\u00a0\u00bb24&Prime; field_type=\u00a0\u00bbradio\u00a0\u00bb radio_options=\u00a0\u00bb%91{%22value%22:%22Non%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Hospitalisation (ou prolongation de celle-ci)%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Incapacit\u00e9 de travail permanente ou invalidit\u00e9%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Mise en danger de la vie%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Anomalies cong\u00e9nitales%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Autres anomalies s\u00e9v\u00e8res ?%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Autre%22,%22checked%22:0,%22dragID%22:5}%93&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb24 Andere\u00a0\u00bb field_id=\u00a0\u00bb24-andere\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%2224%22,%22condition%22:%22is%22,%22value%22:%22Autre%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_padding=\u00a0\u00bb0px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb25. Le m\u00e9dicament a-t-il \u00e9t\u00e9 \u00a0\u00bb field_id=\u00a0\u00bb25&Prime; field_type=\u00a0\u00bbradio\u00a0\u00bb radio_options=\u00a0\u00bb%91{%22value%22:%22Arr\u00eat\u00e9%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Temporairement interrompu%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22R\u00e9duit en dosage%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Augment\u00e9 en dosage%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Inchang\u00e9%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Information inconnue%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Autre%22,%22checked%22:0,%22dragID%22:5}%93&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb25 Andere\u00a0\u00bb field_id=\u00a0\u00bb25-andere\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb conditional_logic=\u00a0\u00bbon\u00a0\u00bb conditional_logic_rules=\u00a0\u00bb%91{%22field%22:%2225%22,%22condition%22:%22is%22,%22value%22:%22Autre%22}%93&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_padding=\u00a0\u00bb0px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb26. Un traitement a-t-il \u00e9t\u00e9 prescrit ?\u00a0\u00bb field_id=\u00a0\u00bb26&Prime; field_type=\u00a0\u00bbtext\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb field_description_text_color=\u00a0\u00bb#494949&Prime; field_description_line_height=\u00a0\u00bb2em\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb27. Informations compl\u00e9mentaires au sujet de l\u2019effet secondaire\u00a0\u00bb field_id=\u00a0\u00bb27&Prime; field_type=\u00a0\u00bbtext\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb field_placeholder=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb field_description_text_color=\u00a0\u00bb#494949&Prime; field_description_line_height=\u00a0\u00bb2em\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bb28. Question\u00a0\u00bb field_id=\u00a0\u00bb28&Prime; field_type=\u00a0\u00bbradio\u00a0\u00bb radio_options=\u00a0\u00bb%91{%22value%22:%22Qualiphar peut me contacter au sujet de cet effet secondaire.%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Je ne souhaite pas que Qualiphar me contacte au sujet de cet effet secondaire%22,%22checked%22:0,%22dragID%22:0}%93&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb field_grid_column=\u00a0\u00bbet_pb_column_2_3&Prime; field_label_position=\u00a0\u00bbtop\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbPrivacy\u00a0\u00bb field_id=\u00a0\u00bbprivacy\u00a0\u00bb field_type=\u00a0\u00bbhtml_content\u00a0\u00bb html_content_editor=\u00a0\u00bb<\/p>\n<h3>Politique de protection de la vie priv\u00e9e<\/h3>\n<p>Les informations demand\u00e9es sur cette page peuvent nous permettre de mieux identifier les risques li\u00e9s au m\u00e9dicament. Ceci est important dans le cadre de la surveillance de la qualit\u00e9 et de l\u2019innocuit\u00e9 de nos produits. Les donn\u00e9es que vous avez saisies contiennent des informations personnelles. Ces informations seront trait\u00e9es de mani\u00e8re strictement confidentielle. Vos informations personnelles seront enregistr\u00e9es dans une base de donn\u00e9es et envoy\u00e9es de mani\u00e8re anonymis\u00e9e aux autorit\u00e9s qui doivent \u00eatre inform\u00e9es de tous les effets secondaires possibles des m\u00e9dicaments. \u00c0 l\u2019exception de ces autorit\u00e9s, vos donn\u00e9es ne seront pas fournies \u00e0 des tiers et elles ne seront pas utilis\u00e9es \u00e0 des fins commerciales.<\/p>\n<p>(i) Le sexe et la date de naissance du\/de la patient(e) nous permettent de v\u00e9rifier si nous avons \u00e9galement re\u00e7u la m\u00eame notification de la part, par exemple, du\/de la m\u00e9decin ou pharmacien(ne).<\/p>\n<p>(ii) Afin de pouvoir traiter une notification d\u2019effet secondaire, nous avons besoin des coordonn\u00e9es de la personne \u00e9mettant la notification. Si vous avez pos\u00e9 une question, nous avons besoin de ces coordonn\u00e9es pour pouvoir vous fournir une r\u00e9ponse.<\/p>\n<p>\u00a0\u00bb _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_margin=\u00a0\u00bb40px||||false|false\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][de_fb_form_field field_title=\u00a0\u00bbPrivacy akkoord\u00a0\u00bb field_id=\u00a0\u00bb30&Prime; field_type=\u00a0\u00bbcheckbox\u00a0\u00bb checkbox_options=\u00a0\u00bb%91{%22value%22:%22J\u2019accepte la politique de protection de la vie priv\u00e9e%22,%22checked%22:0,%22dragID%22:-1}%93&Prime; required_mark=\u00a0\u00bbon\u00a0\u00bb required_message=\u00a0\u00bbSaisissez votre r\u00e9ponse\u00a0\u00bb radio_checkbox_checked_color=\u00a0\u00bb#000000&Prime; _builder_version=\u00a0\u00bb4.19.5&Prime; _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb form_step=\u00a0\u00bb5&Prime; current_step=\u00a0\u00bb1&Prime;][\/de_fb_form_field][\/de_fb_form][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tous les m\u00e9dicaments ont des effets secondaires et sont obligatoirement accompagn\u00e9s d\u2019une notice. Un effet secondaire est un \u00e9v\u00e9nement ind\u00e9sirable ou m\u00e9dical chez un(e) patient(e) qui re\u00e7oit un traitement par un m\u00e9dicament ou un dispositif m\u00e9dical et n\u2019est pas n\u00e9cessairement li\u00e9 \u00e0 ce traitement. Les effets secondaires les plus fr\u00e9quents sont d\u00e9j\u00e0 connus gr\u00e2ce aux [&hellip;]<\/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":"<p>[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><p>Alle geneesmiddelen hebben bijwerkingen en zijn verplicht voorzien van een bijsluiter. Een bijwerking is een ongewenst of medisch voorval bij een pati\u00ebnt die een behandeling krijgt met een geneesmiddel of met een medisch preparaat en dat niet noodzakelijk verband houdt met deze behandeling. De meest voorkomende bijwerkingen zijn al bekend uit klinische studies. Sommige bijwerkingen ontdekken we pas wanneer veel verschillende mensen een geneesmiddel gebruiken. Het is ook mogelijk dat bijwerkingen pas na langdurig gebruik van het geneesmiddel ontstaan en soms ontstaan er bijwerkingen omdat een geneesmiddel in combinatie met andere geneesmiddelen gebruikt wordt.<\/p><p>Voedingssupplementen vallen onder de <a href=\"https:\/\/www.health.belgium.be\/nl\/voeding\/voedingsbeleid\/wetgevend-en-normgevend-kader\/voedingswetgeving\" target=\"_blank\" rel=\"noopener\">voedingswetgeving<\/a> omdat ze wettelijk gezien voeding zijn. Bij voedingssupplementen zijn bijsluiters niet verplicht. Desondanks kunnen ook ongewenste reacties optreden.<\/p><p>[\/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><h3>Het belang van een bijwerking melden<\/h3><p>[\/et_pb_text][et_pb_text _builder_version=\"4.19.5\" custom_margin=\"||40px||false|false\" global_colors_info=\"{}\"]<\/p><p>Qualiphar bewaakt de veiligheid van geneesmiddelen door alle spontane meldingen van pati\u00ebnten of zorgverleners te verzamelen en te onderzoeken. We hebben ook de wettelijke verplichting om alles geanonimiseerd in een internationale databank te verzamelen. In deze internationale databank verzamelen alle landen informatie over bijwerkingen van geneesmiddelen. Als farmaceutische bedrijf worden we regelmatig door het <a href=\"https:\/\/www.fagg.be\/nl\/melden_van_een_bijwerking_als_patient\" target=\"_blank\" rel=\"noopener\">Federaal Agentschap voor Geneesmiddelen en Gezondheidsproducten (FAGG)<\/a> gecontroleerd. Daarom is het belangrijk om altijd uw bijwerking te melden.<\/p><p>[\/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><h3>Hoe meld ik een bijwerking?<\/h3><p>[\/et_pb_text][et_pb_text admin_label=\"Tekst\" _builder_version=\"4.19.5\" custom_margin=\"||40px||false|false\" global_colors_info=\"{}\"]<\/p><p>Om ons te helpen snel en effectief uw informatie te verwerken, vragen wij u om zoveel mogelijk relevante informatie te melden via <a href=\"#contactform\">onderstaand formulier<\/a>. U dient minstens volgende informatie te verstrekken:<\/p><ul><li>De contactinformatie van de melder, namelijk de persoon die de melding doet.<\/li><li>De initialen van de persoon die de mogelijke bijwerking heeft ervaren en\/of andere persoonsgegevens, zoals geslacht, geboortedatum of leeftijd of leeftijdsgroep (bv volwassenen, oudere, kind, baby).<\/li><li>De naam van het geneesmiddel of product van Qualiphar<\/li><li>Een beschrijving van de mogelijke bijwerking, zoals de ervaren symptomen, de datum waarop de mogelijke bijwerking voor het eerst optrad en de uitkomst van de mogelijke bijwerking, kortom zoveel mogelijk info die reeds beschikbaar is.<\/li><\/ul><p>[\/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><h3>Wat gebeurt er met uw melding?<\/h3><p>[\/et_pb_text][et_pb_text _builder_version=\"4.19.5\" custom_margin=\"||40px||false|false\" global_colors_info=\"{}\"]<\/p><ol><li>Onze collega\u2019s van de dienst Pharmacovigilantie verzamelen, registreren en analyseren elke individuele melding.<\/li><li>Wanneer een bijwerking gemeld wordt, is het mogelijk dat Qualiphar bepaalde persoonlijke informatie verzamelt. U vindt hierover meer informatie in de <a href=\"https:\/\/qualiphar.be\/privacy-policy\/\">privacy policy<\/a>.<\/li><li>Elke bijwerking wordt geanonimiseerd en in de lokale databank opgeladen. Indien genoeg gegevens voorhanden zijn, moeten ze ook in de internationale databank worden opgeladen waar ze bekeken worden door de autoriteiten. Experten evalueren die bijwerkingen zodat er actie ondernomen kan worden waar nodig, bijvoorbeeld door de bijsluiter aan te passen of zorgverleners te waarschuwen.<\/li><\/ol><p>Indien u vragen heeft over bijwerkingen met producten van Qualiphar kunt u uiteraard ook Qualiphar rechtstreeks <a href=\"https:\/\/qualiphar.be\/contact\/\">contacteren<\/a>. U mag ook de bijwerking rechtstreeks melden aan het Federaal Agentschap voor Geneesmiddelen en Gezondheidsproducten (FAGG) door te surfen naar <a href=\"https:\/\/www.fagg.be\/nl\/bijwerking\" target=\"_blank\" rel=\"noopener\">www.eenbijwerkingmelden.be<\/a>.<\/p><p>[\/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=\"Meld een bijwerking\" submit_button_text=\"Verzenden\" scrollto_form_after_submit=\"off\" redirect_after_success=\"on\" redirect_url_after_submission=\"@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9saW5rX3VybF9wYWdlIiwic2V0dGluZ3MiOnsicG9zdF9pZCI6IjE3OTgyIn19@\" failed_message=\"Vul het formulier correct in aub%%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=\"Vorige\" step_next_text=\"Volgende\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Contactgegevens melder\" field_id=\"melder\" field_type=\"html_content\" html_content_editor=\"<\/p><h3>Contactgegevens melder<\/h3><p>\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_margin=\"40px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"1. Voornaam\" field_id=\"1\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"2. Familienaam\" field_id=\"2_2\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"3. Telefoon\" field_id=\"3_2\" allowed_symbols=\"numbers\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"4. Email\" field_id=\"4\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"5. Ik ben de\" field_id=\"5\" field_type=\"radio\" radio_options=\"%91{%22value%22:%22Pati\u00ebnt%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Huisarts%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Specialist%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Apotheker%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Verpleger%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Andere%22,%22checked%22:0,%22dragID%22:4}%93\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/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=\"Voer uw antwoord in\" conditional_logic=\"on\" conditional_logic_rules=\"%91{%22field%22:%225%22,%22condition%22:%22is%22,%22value%22:%22Andere%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_padding=\"0px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Step two\" field_id=\"step-2\" field_type=\"step\" step_prev_text=\"Vorige\" step_next_text=\"Volgende\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Gegevens pati\u00ebnt\" field_id=\"pati\u00ebnt\" field_type=\"html_content\" html_content_editor=\"<\/p><h3>Gegevens pati\u00ebnt<\/h3><p>\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_margin=\"40px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"6. Initialen\" field_id=\"6\" required_mark=\"on\" required_message=\"Verplicht invuullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"7. Geslacht\" field_id=\"7\" field_type=\"radio\" radio_options=\"%91{%22value%22:%22M%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22V%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Andere%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=\"{}\"][\/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=\"Voer uw antwoord in\" conditional_logic=\"on\" conditional_logic_rules=\"%91{%22field%22:%227%22,%22condition%22:%22is%22,%22value%22:%22Andere%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_padding=\"0px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"8. Leeftijd\" field_id=\"8\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"9. Werd het middel voorgeschreven?\" field_id=\"9\" field_type=\"radio\" radio_options=\"%91{%22value%22:%22Ja%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Nee%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Andere%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=\"{}\"][\/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=\"Voer uw antwoord in\" conditional_logic=\"on\" conditional_logic_rules=\"%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Andere%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_padding=\"0px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Step three\" field_id=\"step-3\" field_type=\"step\" step_prev_text=\"Vorige\" step_next_text=\"Volgende\" 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\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Gegevens voorschrijver\" field_id=\"voorschrijver\" field_type=\"html_content\" html_content_editor=\"<\/p><h3>Gegegevens voorschrijver<\/h3><p>\" 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\" custom_margin=\"40px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Ga verder\" field_id=\"ga_verder\" field_type=\"html_content\" html_content_editor=\"<\/p><p><strong>Gelieve op de knop %22volgende%22 te klikken<\/strong><\/p><p>\" conditional_logic=\"on\" conditional_logic_rules=\"%91{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Nee%22},{%22field%22:%229%22,%22condition%22:%22is%22,%22value%22:%22Andere%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_margin=\"40px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"10. Naam voorschrijver\" field_id=\"10\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" 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:%22Ja%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"11. Naam instelling\" field_id=\"11\" 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:%22Ja%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"12. Beroep \/ Specialisme\" field_id=\"12\" field_type=\"radio\" radio_options=\"%91{%22value%22:%22Huisarts%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Specialist%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Andere%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:%22Ja%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/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=\"Voer uw antwoord in\" conditional_logic=\"on\" conditional_logic_rules=\"%91{%22field%22:%2212%22,%22condition%22:%22is%22,%22value%22:%22Andere%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_padding=\"0px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"13. Telefoon\" field_id=\"13\" allowed_symbols=\"numbers\" 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:%22Ja%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/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=\"Voer uw antwoord in\" 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\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"15. Ik geef Qualiphar toestemming om over deze bijwerking contact op te nemen met mijn voorschrijver\" field_id=\"15\" field_type=\"radio\" radio_options=\"%91{%22value%22:%22Ja%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Nee%22,%22checked%22:0,%22dragID%22:0}%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:%22Ja%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Step four\" field_id=\"step-4\" field_type=\"step\" step_prev_text=\"Vorige\" step_next_text=\"Volgende\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Geneesmiddel \/ Product\" field_id=\"geneesmiddel\" field_type=\"html_content\" html_content_editor=\"<\/p><h3>Geneesmiddel \/ Product<\/h3><p>\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_margin=\"40px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"16. Naam Geneesmiddel \/ Product\" field_id=\"16\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"17. Farmaceutische vorm\" field_id=\"17\" field_type=\"radio\" radio_options=\"%91{%22value%22:%22Tablet%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Vloeibare vorm%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Zalf%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Poeder%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Andere%22,%22checked%22:0,%22dragID%22:3}%93\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" hover_enabled=\"0\" global_colors_info=\"{}\" sticky_enabled=\"0\"][\/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=\"Voer uw antwoord in\" conditional_logic=\"on\" conditional_logic_rules=\"%91{%22field%22:%2217%22,%22condition%22:%22is%22,%22value%22:%22Andere%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_padding=\"0px||||false|false\" hover_enabled=\"0\" global_colors_info=\"{}\" sticky_enabled=\"0\"][\/de_fb_form_field][de_fb_form_field field_title=\"18. Startdatum gebruik geneesmiddel\" 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=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"19. Dosering\" field_id=\"19\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" description_text=\"on\" description_text_text=\"Welke dosis van het Qualiphar geneesmiddel werd gebruikt?\" _builder_version=\"4.19.5\" _module_preset=\"default\" field_description_line_height=\"2em\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"20. Lotnummer\" field_id=\"20\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" description_text=\"on\" description_text_text=\"Zie verpakking\" _builder_version=\"4.19.5\" _module_preset=\"default\" field_description_line_height=\"2em\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"21. Voor welke indicatie werd het geneesmiddel gebruikt?\" field_id=\"21\" field_type=\"text\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" field_description_text_color=\"#494949\" field_description_line_height=\"2em\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Step five\" field_id=\"step-5\" field_type=\"step\" step_prev_text=\"Vorige\" step_next_text=\"Volgende\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Bijwerking\" field_id=\"bijwerking\" field_type=\"html_content\" html_content_editor=\"<\/p><h3>Bijwerking<\/h3><p>\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_margin=\"40px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"22. Dit betreft een:\" field_id=\"22\" field_type=\"radio\" radio_options=\"%91{%22value%22:%22Bijwerking%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Overdracht van een infectie%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Blootststelling tijdens zwangerschap of borstvoeding (ook zonder bijwerking)%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Verkeerd gebruik%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Misbruik en\/of afhankelijkheid%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Medicatiefout%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Overdosis%22,%22checked%22:0,%22dragID%22:5},{%22value%22:%22 Beroepsblootstelling%22,%22checked%22:0,%22dragID%22:6},{%22value%22:%22Gebrek aan werkzaamheid%22,%22checked%22:0,%22dragID%22:7},{%22value%22:%22Andere%22,%22checked%22:0,%22dragID%22:8}%93\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/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=\"Voer uw antwoord in\" conditional_logic=\"on\" conditional_logic_rules=\"%91{%22field%22:%2222%22,%22condition%22:%22is%22,%22value%22:%22Andere%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_padding=\"0px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"23. Beschrijving bijwerking\" field_id=\"23\" field_type=\"text\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" field_description_text_color=\"#494949\" field_description_line_height=\"2em\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"24. Heeft de bijwerking geleid tot \u00e9\u00e9n van de volgende ernstige situaties?\" field_id=\"24\" field_type=\"radio\" radio_options=\"%91{%22value%22:%22Nee%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Ziekenhuisopname (of verlenging hiervan)%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Blijvende arbeidsongeschiktheid of invaliditeit%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Levensbedreigend%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Aangeboren afwijkingen%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Overige ernstige afwijkingen?%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Andere%22,%22checked%22:0,%22dragID%22:5}%93\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/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=\"Voer uw antwoord in\" conditional_logic=\"on\" conditional_logic_rules=\"%91{%22field%22:%2224%22,%22condition%22:%22is%22,%22value%22:%22Andere%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_padding=\"0px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"25. Werd het geneesmiddel\" field_id=\"25\" field_type=\"radio\" radio_options=\"%91{%22value%22:%22Stopgezet%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Tijdelijk onderbroken%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Dosis verlaagd%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Dosis verhoogd%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Onveranderd%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Onbekend%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Andere%22,%22checked%22:0,%22dragID%22:5}%93\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/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=\"Voer uw antwoord in\" conditional_logic=\"on\" conditional_logic_rules=\"%91{%22field%22:%2225%22,%22condition%22:%22is%22,%22value%22:%22Andere%22}%93\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_padding=\"0px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"26. Werd een behandeling voorgeschreven?\" field_id=\"26\" field_type=\"text\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" field_description_text_color=\"#494949\" field_description_line_height=\"2em\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"27. Bijkomende informatie over de bijwerking\" field_id=\"27\" field_type=\"text\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" field_placeholder=\"Voer uw antwoord in\" _builder_version=\"4.19.5\" _module_preset=\"default\" field_description_text_color=\"#494949\" field_description_line_height=\"2em\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"28. Mag Qualiphar u contacteren over deze bijwerking?\" field_id=\"28\" field_type=\"radio\" radio_options=\"%91{%22value%22:%22Qualiphar mag contact met mij opnemen over deze bijwerking%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Ik wil niet dat Qualiphar contact met mij opneemt over deze bijwerking%22,%22checked%22:0,%22dragID%22:0}%93\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" field_grid_column=\"et_pb_column_2_3\" field_label_position=\"top\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Privacy\" field_id=\"privacy\" field_type=\"html_content\" html_content_editor=\"<\/p><h3>Privacy verklaring<\/h3><p>De gevraagde informatie op deze pagina kan ons in staat stellen geneesmiddel gerelateerde risico's beter te identificeren. Dit is van belang voor de bewaking van de kwaliteit en veiligheid van onze producten. De door u ingevoerde gegevens bevatten persoonlijke informatie. Deze informatie zal strikt vertrouwelijk worden behandeld. Uw persoonsgegevens zullen worden opgenomen in een database en geanonimiseerd doorgestuurd worden naar de overheden die op de hoogte gebracht moeten worden van alle mogelijke bijwerkingen van geneesmiddelen. Uw gegevens zullen, met uitzondering van de overheden, niet aan derden worden verstrekt en niet voor commerci\u00eble doeleinden worden gebruikt.<\/p><p>(i) Aan de hand van het geslacht en de geboortedatum van de pati\u00ebnt kunnen wij nagaan of wij dezelfde melding wellicht ook hebben ontvangen via bijvoorbeeld uw arts of apotheker.<\/p><p>(ii) Om een bijwerking te kunnen verwerken hebben wij gegevens nodig van degene die deze melding doet (de melder). Als u een vraag heeft gesteld hebben wij deze gegevens nodig om u een antwoord te geven.<\/p><p>\" _builder_version=\"4.19.5\" _module_preset=\"default\" custom_margin=\"40px||||false|false\" global_colors_info=\"{}\"][\/de_fb_form_field][de_fb_form_field field_title=\"Privacy akkoord\" field_id=\"30\" field_type=\"checkbox\" checkbox_options=\"%91{%22value%22:%22Ik ga akkoord met de privacy verklaring*%22,%22checked%22:0,%22dragID%22:-1}%93\" required_mark=\"on\" required_message=\"Verplicht invullen aub\" radio_checkbox_checked_color=\"#000000\" _builder_version=\"4.19.5\" _module_preset=\"default\" global_colors_info=\"{}\"][\/de_fb_form_field][\/de_fb_form][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>","_et_gb_content_width":"","footnotes":""},"class_list":["post-18481","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Signaler un effet ind\u00e9sirable - 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