Notification of a quality problem with the medicine, incorrect information on the medicine or suspicion of counterfeiting

Form

Current Notifier
Medicine
Description of the problem
Completed

Notifier

Notifier's e-mail address (A copy of the notification will be sent to this address after the notification has been submitted)

First and last name and contact details (telephone number; if representing an institution or company, also its name, address and your position)

Medicine

The name of the medicine

Active ingredients of the medicine and their dose

Pharmaceutical form (e.g. tablets, ointment, etc.)

Package size (e.g. number of tablets, ml)

Type of packaging (e.g. blister packaging in a cardboard box)

Name of manufacturer or marketing authorization holder

Batch or series number (Batch, Lot, embossed or printed on the package)

From whom and where was the medicine obtained or purchased (for example, the name and location of the pharmacy)?

Date of purchase or delivery of the medicine

Upload photos of the package

Select a file (gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip)

Description of the problem

Please describe the problem as precisely as possible

When was the problem discovered?

Is the problem also with other packages of the same medicine?

Yes

If the problem also occurred with other packages of the same medicine, add the package data - product code (GTIN), serial number (SN) and batch number (LOT, Batch)

Has the problem been reported to the pharmacy, wholesaler, representative of the drug manufacturer/marketing authorization holder, or the Drug Authenticity Control System SA, and what response was received?

Additional information

Last updated: 15.11.2024

Medicinal products

Marketing authorisations

Manufacture, distribution, pharmacy

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Statistics

State Agency of Medicines

Contact Information

Contacts

Notify us

Notification of a quality problem with the medicine, incorrect information on the medicine or suspicion of counterfeiting

Form

Notifier

Medicine

Description of the problem

Medicinal products

Marketing authorisations

Manufacture, distribution, pharmacy

Medicines Across the Border

Drug information and safety

Quality and standars

Clinical trials

Medical Devices

Blood

Cells, tissues and organs

Advanced medicinal products

NARCOTIC DRUGS, PSYCHOTROPIC SUBSTANCES AND DRUG PRECURSORS

All about statistics

Statistics

State Agency of Medicines

Contact Information

Contacts

Notify us

Notification of a quality problem with the medicine, incorrect information on the medicine or suspicion of counterfeiting

Form

Notifier

Medicine

Description of the problem