Adverse Reaction Reporting – Celon Pharma S.A.

In accordance with the legal requirements of the Pharmaceutical Law Act of 6 September 2001, Celon Pharma S.A., as the marketing authorization holder, is obliged to collect all information regarding the occurrence of adverse reactions resulting from the use of medicinal products for which it holds marketing authorization. Reporting adverse reactions helps gather more information about the safety of the medicine.

An adverse reaction is any harmful and unintended response to a medicinal product.

Reporting Instructions
• By phone: +48 22 751 59 33 (available during office hours, 8:00 AM – 4:00 PM).
• By form: Fill out the [ADVERSE DRUG REACTION REPORTING FORM] and send a scanned copy to: dzialania.niepozadane@celonpharma.com.
• Or mail the original to: Celon Pharma S.A., Ogrodowa 2A, 05-092 Łomianki / Kiełpin, with the note 'Adverse Reactions'.

You may also report using the online form below.
Fields marked with an asterisk (*) are mandatory.

    Product and Adverse Reaction Information
    NoYes
    deathlife-threateninghospitalization or its prolongationpermanent or significant disabilitycongenital anomalyother medically important condition
    RecoveryCurrently under treatmentRecovery with permanent effectsUnknown
    Patient Information
    FemaleMale
    YesNo
    Reporter’s Information
    PatientPhysicianPharmacistOther healthcare professional (specify below).

    The data controller of your personal information is the marketing authorization holder of the medicinal product to which the report relates: Celon Pharma S.A., mailing address: Marymoncka 15, Kazuń Nowy, 05-152 Czosnów.

    You may contact the Data Controller in writing – at the address above. For all matters related to personal data protection, you may contact the Data Protection Officer at iod@celonpharma.com.

    Providing your personal data in the form is voluntary. Detailed information about the processing of personal data in connection with the completion and submission of the form can be found here

    In case of reporting information about the use of a drug by a pregnant woman, please download and complete the form: [EXPOSURE TO MEDICINAL PRODUCT DURING PREGNANCY FORM]