Information about all adverse effects of Sintez JSC medicines can be forwarded to the authorized person for pharmacovigilance as follows: Fill in the online "Adverse Drug Reaction" notification form. Call us in Moscow 8 (495) 137-57-27 Ext. 1048; and/or in Kurgan 8 (3522) 48-14-48. Send an e-mail message to: Send a fax to: (3522) 48-12-33 marked "Pharmacovigilance" Send information by regular mail: building 7, Prospekt Konstitutsii, the city of Kurgan, 640008 or building 10a, Bolshoy Savvinsky pereulok, Moscow, 119435 (marked "Pharmacovigilance")

Full name and age:
Your sex:
Name of medication/its form:
Series of medication:
What adverse effects
has this medication caused:
What concurrent
medications have been taken? :
What was used to wash down
this medication? :
What measures have been taken
to eliminate the adverse reaction? :
The medication has been prescribed by: