{"id":1780,"date":"2023-09-02T17:33:54","date_gmt":"2023-09-02T14:33:54","guid":{"rendered":"https:\/\/alafiapharma.com\/afia\/?page_id=1780"},"modified":"2026-01-14T12:44:36","modified_gmt":"2026-01-14T09:44:36","slug":"report-side-effect","status":"publish","type":"page","link":"https:\/\/alafiapharma.com\/afia\/report-side-effect\/","title":{"rendered":"Report side effect"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column offset=&#8221;vc_col-lg-12 vc_col-md-12&#8243;][vc_custom_heading text=&#8221;Report side effect&#8221; use_theme_fonts=&#8221;yes&#8221; el_class=&#8221;m-b-xs&#8221;][vc_empty_space][\/vc_column][\/vc_row][vc_row][vc_column offset=&#8221;vc_col-md-8&#8243;][vc_column_text el_class=&#8221;lead&#8221;]<\/p>\n<h4><span style=\"font-size: 19px;\">Whats is Side effect?<\/span><\/h4>\n<p>A side effect is an unintended effect of a drug or medical treatment. It can be any unwanted or unpleasant effect, whether it is mild or severe. Side effects can vary from person to person and can depend on the drug, the dosage, and the individual&#8217;s health.<\/p>\n<h4><span style=\"font-size: 19px;\">why Reporting side effects is Important?<\/span><\/h4>\n<p>Reporting side effects of our products helps us to ensure the safety of our products and our patients. Your information will also help us to fulfill our reporting responsibilities to health authorities. We are required to provide information on side effects with our products, even if there is no clear link between the product and the effect. 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.<\/p>\n<h4><span style=\"font-size: 19px;\">How to report side effects?<\/span><\/h4>\n<p>you can report side effects electronically through oir website by pressing the link below :[\/vc_column_text][\/vc_column][vc_column offset=&#8221;vc_col-md-4&#8243;][vc_empty_space][vc_single_image source=&#8221;external_link&#8221; external_img_size=&#8221;360&#215;180&#8243; alignment=&#8221;center&#8221; custom_src=&#8221;https:\/\/alafiapharma.com\/afia\/wp-content\/uploads\/2023\/08\/02a74331-85f8-4898-bed1-00a08326d9d2.jpg&#8221;][\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row&#8221; is_section=&#8221;yes&#8221; conditional_render=&#8221;%5B%7B%22value_role%22%3A%22administrator%22%7D%5D&#8221; css=&#8221;.vc_custom_1768383870064{margin-bottom: -45px !important;background-color: #ffffff !important;border-color: #ffffff !important;}&#8221;][vc_column css=&#8221;.vc_custom_1768383656261{background-color: #ffffff !important;border-color: #ffffff !important;}&#8221; conditional_render=&#8221;%5B%7B%22value_role%22%3A%22administrator%22%7D%5D&#8221;][vc_empty_space css=&#8221;.vc_custom_1768383818078{background-color: #ffffff !important;border-color: #ffffff !important;}&#8221;]\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1997-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1997\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/afia\/wp-json\/wp\/v2\/pages\/1780#wpcf7-f1997-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1997\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.4\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1997-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"pv-form-wrapper\">\n\n <!-- Section 1: Reporter Details -->\n\t<div class=\"pv-section\">\n\t\t<h3 class=\"pv-heading\"><br \/>\nReporter Details<br \/>\n<span class=\"ar-heading\">\u062a\u0641\u0627\u0635\u064a\u0644 \u0627\u0644\u0645\u064f\u0628\u0644\u0651\u063a<\/span>\n\t\t<\/h3>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col full\">\n\t\t\t\t<p><label class=\"main-label\">You are \/ <span class=\"ar-text\">\u0623\u0646\u062a:<\/span><\/label>\n\t\t\t\t<\/p>\n\t\t\t\t<div class=\"radio-group-wrapper\">\n\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"reporter-type\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"reporter-type\" value=\"Patient (user) \/ \u0645\u0631\u064a\u0636 (\u0645\u0633\u062a\u062e\u062f\u0645)\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Patient (user) \/ \u0645\u0631\u064a\u0636 (\u0645\u0633\u062a\u062e\u062f\u0645)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"reporter-type\" value=\"Parent \/ \u0648\u0627\u0644\u062f\/\u0648\u0627\u0644\u062f\u0629\" \/><span class=\"wpcf7-list-item-label\">Parent \/ \u0648\u0627\u0644\u062f\/\u0648\u0627\u0644\u062f\u0629<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"reporter-type\" value=\"Other non-medical person \/ \u0634\u062e\u0635 \u063a\u064a\u0631 \u0637\u0628\u064a\" \/><span class=\"wpcf7-list-item-label\">Other non-medical person \/ \u0634\u062e\u0635 \u063a\u064a\u0631 \u0637\u0628\u064a<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"reporter-type\" value=\"Medical specialist \/ \u0623\u062e\u0635\u0627\u0626\u064a \u0637\u0628\u064a\" \/><span class=\"wpcf7-list-item-label\">Medical specialist \/ \u0623\u062e\u0635\u0627\u0626\u064a \u0637\u0628\u064a<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Name \/ <span class=\"ar-text\">\u0627\u0644\u0627\u0633\u0645<\/span> (*)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reporter-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"name\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Full Name \/ \u0627\u0644\u0627\u0633\u0645 \u0627\u0644\u0643\u0627\u0645\u0644\" value=\"\" type=\"text\" name=\"reporter-name\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Phone \/ <span class=\"ar-text\">\u0627\u0644\u0647\u0627\u062a\u0641<\/span> (*)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reporter-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" autocomplete=\"tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"+218...\" value=\"\" type=\"tel\" name=\"reporter-phone\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Email \/ <span class=\"ar-text\">\u0627\u0644\u0628\u0631\u064a\u062f \u0627\u0644\u0625\u0644\u0643\u062a\u0631\u0648\u0646\u064a<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reporter-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" autocomplete=\"email\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"reporter-email\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Date of report \/ <span class=\"ar-text\">\u062a\u0627\u0631\u064a\u062e \u0627\u0644\u062a\u0642\u0631\u064a\u0631<\/span> (*)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"report-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"report-date\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col full\">\n\t\t\t\t<p><label>Address \/ <span class=\"ar-text\">\u0627\u0644\u0639\u0646\u0648\u0627\u0646<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reporter-address\"><textarea cols=\"40\" rows=\"2\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"City, Street... \/ \u0627\u0644\u0645\u062f\u064a\u0646\u0629\u060c \u0627\u0644\u0634\u0627\u0631\u0639...\" name=\"reporter-address\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n <!-- Section 2: Patient Information -->\n\t<div class=\"pv-section\">\n\t\t<h3 class=\"pv-heading\"><br \/>\nPatient Information<br \/>\n<span class=\"ar-heading\">\u0645\u0639\u0644\u0648\u0645\u0627\u062a \u0627\u0644\u0645\u0631\u064a\u0636<\/span>\n\t\t<\/h3>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col third\">\n\t\t\t\t<p><label>Initials \/ <span class=\"ar-text\">\u0627\u0644\u0623\u062d\u0631\u0641 \u0627\u0644\u0623\u0648\u0644\u0649<\/span> (*)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-initials\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-initials\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col third\">\n\t\t\t\t<p><label>Age \/ <span class=\"ar-text\">\u0627\u0644\u0639\u0645\u0631<\/span> (*)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-age\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"patient-age\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col third\">\n\t\t\t\t<p><label>Sex \/ <span class=\"ar-text\">\u0627\u0644\u062c\u0646\u0633<\/span> (*)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-sex\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"patient-sex\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Female \/ \u0623\u0646\u062b\u0649\">Female \/ \u0623\u0646\u062b\u0649<\/option><option value=\"Male \/ \u0630\u0643\u0631\">Male \/ \u0630\u0643\u0631<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Weight (kg) \/ <span class=\"ar-text\">\u0627\u0644\u0648\u0632\u0646 (\u0643\u062c\u0645)<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-weight\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" step=\"0.1\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"patient-weight\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Height (cm) \/ <span class=\"ar-text\">\u0627\u0644\u0637\u0648\u0644 (\u0633\u0645)<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"patient-height\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" step=\"1\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"patient-height\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n <!-- Section 3: Suspected Drug -->\n\t<div class=\"pv-section\">\n\t\t<h3 class=\"pv-heading\"><br \/>\nInformation on the Suspected Drug<br \/>\n<span class=\"ar-heading\">\u0645\u0639\u0644\u0648\u0645\u0627\u062a \u0639\u0646 \u0627\u0644\u062f\u0648\u0627\u0621 \u0627\u0644\u0645\u0634\u062a\u0628\u0647 \u0628\u0647<\/span>\n\t\t<\/h3>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Product Name \/ <span class=\"ar-text\">\u0627\u0633\u0645 \u0627\u0644\u0645\u0646\u062a\u062c<\/span> (*)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"drug-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"drug-name\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Form & Strength \/ <span class=\"ar-text\">\u0627\u0644\u0634\u0643\u0644 \u0648\u0627\u0644\u062a\u0631\u0643\u064a\u0632<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"drug-form\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"drug-form\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Tab \/ \u0623\u0642\u0631\u0627\u0635\">Tab \/ \u0623\u0642\u0631\u0627\u0635<\/option><option value=\"Syrup \/ \u0634\u0631\u0627\u0628\">Syrup \/ \u0634\u0631\u0627\u0628<\/option><option value=\"Injection \/ \u062d\u0642\u0646\">Injection \/ \u062d\u0642\u0646<\/option><option value=\"Inhaler \/ \u0628\u062e\u0627\u062e\">Inhaler \/ \u0628\u062e\u0627\u062e<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col half\">\n <!-- CHANGE: Label updated to Company Name -->\n\t\t\t\t<p><label>Company Name \/ <span class=\"ar-text\">\u0627\u0644\u0634\u0631\u0643\u0629 \u0627\u0644\u0645\u0635\u0646\u0639\u0629<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"drug-company\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"drug-company\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Batch Number \/ <span class=\"ar-text\">\u0631\u0642\u0645 \u0627\u0644\u062a\u0634\u063a\u064a\u0644\u0629<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"drug-batch\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"drug-batch\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col full\">\n\t\t\t\t<p><label>Why was the drug prescribed? \/ <span class=\"ar-text\">\u0644\u0645\u0627\u0630\u0627 \u062a\u0645 \u0648\u0635\u0641 \u0627\u0644\u062f\u0648\u0627\u0621\u061f<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"drug-reason\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"drug-reason\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col third\">\n\t\t\t\t<p><label>Route \/ <span class=\"ar-text\">\u0637\u0631\u064a\u0642\u0629 \u0627\u0644\u0625\u0639\u0637\u0627\u0621<\/span> (*)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"drug-route\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"drug-route\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Oral \/ \u0628\u0627\u0644\u0641\u0645\">Oral \/ \u0628\u0627\u0644\u0641\u0645<\/option><option value=\"IV \/ \u0641\u064a \u0627\u0644\u0648\u0631\u064a\u062f\">IV \/ \u0641\u064a \u0627\u0644\u0648\u0631\u064a\u062f<\/option><option value=\"IM \/ \u0641\u064a \u0627\u0644\u0639\u0636\u0644\">IM \/ \u0641\u064a \u0627\u0644\u0639\u0636\u0644<\/option><option value=\"Supp \/ \u062a\u062d\u0645\u064a\u0644\u0629\">Supp \/ \u062a\u062d\u0645\u064a\u0644\u0629<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col third\">\n\t\t\t\t<p><label>Start Date \/ <span class=\"ar-text\">\u062a\u0627\u0631\u064a\u062e \u0627\u0644\u0628\u062f\u0621<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"drug-start-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"drug-start-date\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col third\">\n\t\t\t\t<p><label>End Date \/ <span class=\"ar-text\">\u062a\u0627\u0631\u064a\u062e \u0627\u0644\u0627\u0646\u062a\u0647\u0627\u0621<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"drug-end-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"drug-end-date\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col full checkbox-group\">\n\t\t\t\t<p><label class=\"main-label\">Treatment Status \/ <span class=\"ar-text\">\u062d\u0627\u0644\u0629 \u0627\u0644\u0639\u0644\u0627\u062c<\/span>:<\/label><br \/>\n<label>Treatment Status \/ <span class=\"ar-text\">\u062d\u0627\u0644\u0629 \u0627\u0644\u0639\u0644\u0627\u062c<\/span> (*)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"drug-action\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"drug-action\" value=\"Treatment discontinued \/ \u062a\u0645 \u0625\u064a\u0642\u0627\u0641 \u0627\u0644\u0639\u0644\u0627\u062c\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Treatment discontinued \/ \u062a\u0645 \u0625\u064a\u0642\u0627\u0641 \u0627\u0644\u0639\u0644\u0627\u062c<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"drug-action\" value=\"Treatment NOT discontinued \/ \u0644\u0645 \u064a\u062a\u0645 \u0625\u064a\u0642\u0627\u0641 \u0627\u0644\u0639\u0644\u0627\u062c\" \/><span class=\"wpcf7-list-item-label\">Treatment NOT discontinued \/ \u0644\u0645 \u064a\u062a\u0645 \u0625\u064a\u0642\u0627\u0641 \u0627\u0644\u0639\u0644\u0627\u062c<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col full\">\n\t\t\t\t<p><label>Additional info on drug \/ <span class=\"ar-text\">\u0645\u0639\u0644\u0648\u0645\u0627\u062a \u0625\u0636\u0627\u0641\u064a\u0629 \u0639\u0646 \u0627\u0644\u062f\u0648\u0627\u0621<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"drug-additional-info\"><textarea cols=\"40\" rows=\"2\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"drug-additional-info\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col full\">\n\t\t\t\t<p><label>Other medications taken currently \/ <span class=\"ar-text\">\u0623\u062f\u0648\u064a\u0629 \u0623\u062e\u0631\u0649 \u064a\u062a\u0645 \u062a\u0646\u0627\u0648\u0644\u0647\u0627 \u062d\u0627\u0644\u064a\u0627\u064b<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-meds\"><textarea cols=\"40\" rows=\"2\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"other-meds\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n <!-- Section 4: Adverse Reaction -->\n\t<div class=\"pv-section\">\n\t\t<h3 class=\"pv-heading\"><br \/>\nAdverse Reaction (ADR)<br \/>\n<span class=\"ar-heading\">\u0627\u0644\u062a\u0641\u0627\u0639\u0644 \u0627\u0644\u0636\u0627\u0631 (\u0627\u0644\u0639\u0631\u0636 \u0627\u0644\u062c\u0627\u0646\u0628\u064a)<\/span>\n\t\t<\/h3>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col full\">\n\t\t\t\t<p><label>Description of reaction \/ <span class=\"ar-text\">\u0648\u0635\u0641 \u0627\u0644\u062a\u0641\u0627\u0639\u0644<\/span> (*)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reaction-description\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"reaction-description\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Duration of reaction \/ <span class=\"ar-text\">\u0645\u062f\u0629 \u0627\u0644\u062a\u0641\u0627\u0639\u0644<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reaction-duration\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"reaction-duration\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Measures taken? \/ <span class=\"ar-text\">\u0627\u0644\u0625\u062c\u0631\u0627\u0621\u0627\u062a \u0627\u0644\u0645\u062a\u062e\u0630\u0629\u061f<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reaction-measures\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"reaction-measures\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Outcome \/ <span class=\"ar-text\">\u0627\u0644\u0646\u062a\u064a\u062c\u0629<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reaction-outcome\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"reaction-outcome\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Recovery \/ \u062a\u0639\u0627\u0641\u064a\">Recovery \/ \u062a\u0639\u0627\u0641\u064a<\/option><option value=\"Recovery with consequences \/ \u062a\u0639\u0627\u0641\u064a \u0645\u0639 \u0622\u062b\u0627\u0631\">Recovery with consequences \/ \u062a\u0639\u0627\u0641\u064a \u0645\u0639 \u0622\u062b\u0627\u0631<\/option><option value=\"Recovery continues \/ \u0627\u0644\u062a\u0639\u0627\u0641\u064a \u0645\u0633\u062a\u0645\u0631\">Recovery continues \/ \u0627\u0644\u062a\u0639\u0627\u0641\u064a \u0645\u0633\u062a\u0645\u0631<\/option><option value=\"Reaction continues \/ \u0627\u0644\u0639\u0631\u0636 \u0645\u0633\u062a\u0645\u0631\">Reaction continues \/ \u0627\u0644\u0639\u0631\u0636 \u0645\u0633\u062a\u0645\u0631<\/option><option value=\"Death \/ \u0648\u0641\u0627\u0629\">Death \/ \u0648\u0641\u0627\u0629<\/option><option value=\"Unknown \/ \u063a\u064a\u0631 \u0645\u0639\u0631\u0648\u0641\">Unknown \/ \u063a\u064a\u0631 \u0645\u0639\u0631\u0648\u0641<\/option><option value=\"Other \/ \u0622\u062e\u0631\">Other \/ \u0622\u062e\u0631<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Impact on daily activities \/ <span class=\"ar-text\">\u0627\u0644\u062a\u0623\u062b\u064a\u0631 \u0639\u0644\u0649 \u0627\u0644\u062d\u064a\u0627\u0629 \u0627\u0644\u064a\u0648\u0645\u064a\u0629<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reaction-impact\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"reaction-impact\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Mild inconvenience \/ \u0625\u0632\u0639\u0627\u062c \u0628\u0633\u064a\u0637\">Mild inconvenience \/ \u0625\u0632\u0639\u0627\u062c \u0628\u0633\u064a\u0637<\/option><option value=\"Incapacity \/ \u0639\u062c\u0632\">Incapacity \/ \u0639\u062c\u0632<\/option><option value=\"Hospital admission \/ \u062f\u062e\u0648\u0644 \u0627\u0644\u0645\u0633\u062a\u0634\u0641\u0649\">Hospital admission \/ \u062f\u062e\u0648\u0644 \u0627\u0644\u0645\u0633\u062a\u0634\u0641\u0649<\/option><option value=\"Life-saving measures \/ \u0625\u062c\u0631\u0627\u0621\u0627\u062a \u0645\u0646\u0642\u0630\u0629 \u0644\u0644\u062d\u064a\u0627\u0629\">Life-saving measures \/ \u0625\u062c\u0631\u0627\u0621\u0627\u062a \u0645\u0646\u0642\u0630\u0629 \u0644\u0644\u062d\u064a\u0627\u0629<\/option><option value=\"Disability \/ \u0625\u0639\u0627\u0642\u0629\">Disability \/ \u0625\u0639\u0627\u0642\u0629<\/option><option value=\"Other \/ \u0622\u062e\u0631\">Other \/ \u0622\u062e\u0631<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col full\">\n\t\t\t\t<p><label>Possible cause \/ <span class=\"ar-text\">\u0627\u0644\u0633\u0628\u0628 \u0627\u0644\u0645\u062d\u062a\u0645\u0644<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"reaction-additional\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"reaction-additional\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n <!-- Section 5: Doctor Info -->\n\t<div class=\"pv-section\">\n\t\t<h3 class=\"pv-heading\"><br \/>\nDoctor Information<br \/>\n<span class=\"ar-heading\">\u0645\u0639\u0644\u0648\u0645\u0627\u062a \u0627\u0644\u0637\u0628\u064a\u0628<\/span>\n\t\t<\/h3>\n\t\t<div class=\"pv-row\">\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Doctor Name \/ <span class=\"ar-text\">\u0627\u0633\u0645 \u0627\u0644\u0637\u0628\u064a\u0628<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"doctor-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"doctor-name\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"pv-col half\">\n\t\t\t\t<p><label>Contact (Phone\/Email) \/ <span class=\"ar-text\">\u0645\u0639\u0644\u0648\u0645\u0627\u062a \u0627\u0644\u0627\u062a\u0635\u0627\u0644<\/span><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"doctor-contact\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"doctor-contact\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"pv-row submit-row\">\n\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit Report \/ \u0625\u0631\u0633\u0627\u0644 \u0627\u0644\u062a\u0642\u0631\u064a\u0631\" \/>\n\t\t<\/p>\n\t<\/div>\n<\/div><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"172\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n[\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column offset=&#8221;vc_col-lg-12 vc_col-md-12&#8243;][vc_custom_heading text=&#8221;Report side effect&#8221; use_theme_fonts=&#8221;yes&#8221; el_class=&#8221;m-b-xs&#8221;][vc_empty_space][\/vc_column][\/vc_row][vc_row][vc_column offset=&#8221;vc_col-md-8&#8243;][vc_column_text el_class=&#8221;lead&#8221;] Whats is Side effect? A side effect is an unintended effect of a drug or medical treatment. It can be any unwanted or unpleasant effect, whether it is mild or severe. Side effects can vary from person to person and can depend on the drug, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1780","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/alafiapharma.com\/afia\/wp-json\/wp\/v2\/pages\/1780","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/alafiapharma.com\/afia\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/alafiapharma.com\/afia\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/alafiapharma.com\/afia\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/alafiapharma.com\/afia\/wp-json\/wp\/v2\/comments?post=1780"}],"version-history":[{"count":17,"href":"https:\/\/alafiapharma.com\/afia\/wp-json\/wp\/v2\/pages\/1780\/revisions"}],"predecessor-version":[{"id":2021,"href":"https:\/\/alafiapharma.com\/afia\/wp-json\/wp\/v2\/pages\/1780\/revisions\/2021"}],"wp:attachment":[{"href":"https:\/\/alafiapharma.com\/afia\/wp-json\/wp\/v2\/media?parent=1780"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}