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Adorateb ADR Form

ADR Form

If you observe any side effects or have an adverse reaction from using products distributed by Adorateb Company, please inform us via one of the following methods:

Contact No.: 021-88385681
Email: pv@adorateb.ir
Complete the following Side Effects Report Form (ADR):

Form ADR

Patient information
Medications suspected of having a complication
Reporter information

First name and Last name

Age

Weight

Mobile

Phone

Address

Complication onset date

How long has the complication lasted?

A history of any past drug side effects for the patient

Gender Man Woman

Patient history Allergy Hereditary disease Enzymatic violation Current diseases Addiction

Has the complication reappeared after repeated use of the drug? Yes No The medicine has not been used again

Has the side effect decreased after stopping the drug? Yes No The medicine has not been stopped

Finally the drug side effect: Recovery Lack of recovery Maim Death

Has the drug complication led to the hospitalization of the patient? Yes No

Paraclinical drug findings related to the observed complication

Next

Drug name (brand or generic)

The shape and power of medicine

Daily intake

Ways to consume

Consumable

Date of use

Expiry date

Manufacturing factory

Construction Series

Reporter Profile Doctor Pharmacist Nurse Expert Patient Other

Name and surname of the reporter

Medical system number

Name of medical center

Mobile Reporter

Reporter Phone

Reporter's full mailing address

Adorateb Company was founded in 2008 as a Cobel Group nationwide distribution company to sell and distribute pharmaceuticals, medical equipment, and supplements throughout Iran. Adorateb offers capillary distribution services to over fifteen thousand pharmacies, hospitals, and medical facilities while complying with international standards for the storage and distribution of pharmaceutical products. These products include manufactured and imported goods from leading companies such as Cobel Darou, Dr. Abidi Pharmaceuticals, Nestlé, Roche, and others.

Contacts

021-88385660-80
adora@adorateb.ir
No. 114, Dadman Blvd., Shahrak Gharb, Tehran

Reference links

Ministry of Health and Medical Education
Food and Drug Administration
Cobel Darou Company
Dr. Abidi Pharmaceutical Company

Useful links

Job Opportunities
Reporting Pharmaceutical Side Effects
Adorateb Products

All rights reserved by Adorateb company.

Complaints021-88385681

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