All medicines have potential side effects as well as benefits. We routinely monitor the safety and quality of all our products. This includes review of safety data from clinical studies and review of side effects and technical complaints. By monitoring quality and safety information on our products, we can take due and appropriate actions to safeguard patient safety.
If you or the person you are reporting on behalf of are currently suffering from severe side effects, you should contact your local doctor or other medical health professional before reporting the side effect.
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Reporter information

First name *

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Last name *

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Check if you are an healthcare professional (HCP) * *
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Address 1 *

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Address 2 *

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Town *

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County *

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Postcode *

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Phone number *

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E-mail *

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Information about the person who experienced the side effect

Who experienced the side effects? * *
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Age at the time of the side effect *

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Information about the medicine

Name of the product *

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The product batch/LOT number *

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Product start date *

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Product stop date *

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Product dosage and frequency *

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Describe the condition for which the product was taken *

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Please describe the side effect(s) *

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Start date of side effect *

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Stop date of side effect *

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Consent and data privacy

Notice of personal data processing * *
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May Novo Nordisk contact you for further information, if needed? * *
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May Novo Nordisk contact your doctor for further information, if needed? * *
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Doctor's contact information *

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