Nabiqasim Industries
Pharmacovigilance

Drug Safety Reporting

Report suspected adverse events through the online form below or download the offline reporting form for manual submission.

Report Instructions

Suspected Adverse Drug Event Reporting Form

Use this form for voluntary and spontaneous reporting of adverse drug reactions related to products marketed by Nabiqasim. Provide as much clinical and product detail as possible so the pharmacovigilance team can assess the report accurately.

Serious and complete reporting

Include event narrative, product details, seriousness, outcome, and relevant concomitant history exactly as known.

Safety contact

For follow-up, the report will be reviewed by medsafety@nabiqasim.com.

Online form

Submit a report directly online

Use the digital reporting flow to send the case directly to the Nabiqasim pharmacovigilance team with all required patient, product, and event details.

Submit Report

Reports are reviewed by the Nabiqasim pharmacovigilance team.

Safety contact

For follow-up, the report will be reviewed by medsafety@nabiqasim.com.

Compulsory information

Complete the form as accurately as possible. Fields marked with an asterisk are required for submission.

A.

Patient Information

Match the patient details to the suspected adverse drug event as closely as possible.

B.

Product Information

Capture the suspected product details exactly as reported.

C.

Event Information

Document the event narrative, seriousness, and clinical outcome.

You consider the problem related to which of the following *

Outcome *

D.

Other Drug(s)/ Alternative Medicine(s) and History

E.

Reporter Information

If needed, our team may contact you at medsafety@nabiqasim.com for follow-up.

Reports are reviewed by the Nabiqasim pharmacovigilance team.