欢迎来到不良事件报告页面

  • 1.何为不良反应?

    药品不良反应(ADR):是指合格药品在正常用法用量下出现的与用药目的无关的有害反应。药品不良反应≠质量问题

  • 2.为何要上报不良事件?

    金赛药业建立了多种收集渠道对产品安全性持续监测,通过您上报的金赛产品不良事件/反应,可帮助我们持续完善产品安全性特征,确保患者的用药安全。

  • 3.如何报告不良事件?

    如果您发生不良事件,应及时咨询医生,同时请您填写不良事件/反应报告表,也可以拨打药品说明中热线电话报告不良事件/反应。对于您报告的不良事件/反应,在此表示感谢!祝您和您的家人身体健康!

  • 4.隐私说明

    金赛药业会遵守隐私法,对您及您上报的信息全程保密,请您放心填写!

患者信息

姓名*

性別*

出生日期*

省份*

处方医院*

用药原因*

怀疑药品信息
array(2) {
  [0] => array(25) {
    ["id"] => string(1) "2"
    ["catid"] => string(2) "18"
    ["title"] => string(36) "长春金赛药业有限责任公司"
    ["thumb"] => array(2) {
      ["thumb"] => string(0) ""
      ["alt"] => string(0) ""
    }
    ["keywords"] => string(0) ""
    ["description"] => string(0) ""
    ["content"] => string(0) ""
    ["url"] => string(0) ""
    ["count"] => string(1) "0"
    ["sort"] => string(1) "0"
    ["command"] => string(1) "0"
    ["isdel"] => string(1) "0"
    ["free"] => string(1) "0"
    ["status"] => string(1) "1"
    ["uid"] => string(1) "1"
    ["username"] => string(9) "supertech"
    ["euid"] => string(1) "4"
    ["edituser"] => string(11) "system-2022"
    ["input_time"] => string(10) "1693896357"
    ["create_time"] => string(10) "1693883568"
    ["update_time"] => string(10) "1729218952"
    ["custom_code"] => string(0) ""
    ["static_title"] => string(0) ""
    ["email"] => string(19) "adr@genscigroup.com"
    ["group"] => array(12) {
      [0] => array(1) {
        ["s1gtitle"] => string(36) "注射用人生长激素(赛增)"
      }
      [1] => array(1) {
        ["s1gtitle"] => string(42) "重组人生长激素注射液(赛增)"
      }
      [2] => array(1) {
        ["s1gtitle"] => string(57) "聚乙二醇重组人生长激素注射液(金赛增)"
      }
      [3] => array(1) {
        ["s1gtitle"] => string(48) "注射用重组人促卵泡激素(金赛恒)"
      }
      [4] => array(1) {
        ["s1gtitle"] => string(45) "人粒细胞刺激因子注射液(赛强)"
      }
      [5] => array(1) {
        ["s1gtitle"] => string(39) "注射用醋酸奥曲肽(金迪林)"
      }
      [6] => array(1) {
        ["s1gtitle"] => string(27) "醋酸曲普瑞林注射液"
      }
      [7] => array(1) {
        ["s1gtitle"] => string(63) "外用人粒细胞巨噬细胞刺激因子凝胶(金扶宁)"
      }
      [8] => array(1) {
        ["s1gtitle"] => string(42) "注射用醋酸西曲瑞克(金赛捷)"
      }
      [9] => array(1) {
        ["s1gtitle"] => string(48) "重组人促卵泡激素注射液(金赛恒)"
      }
      [10] => array(1) {
        ["s1gtitle"] => string(48) "醋酸甲地孕酮口服混悬液(美适亚)"
      }
      [11] => array(1) {
        ["s1gtitle"] => string(41) "黄体酮注射液(II)(金赛欣)"
      }
    }
  }
  [1] => array(25) {
    ["id"] => string(1) "1"
    ["catid"] => string(2) "18"
    ["title"] => string(39) "北京金赛增医疗科技有限公司"
    ["thumb"] => array(2) {
      ["thumb"] => string(0) ""
      ["alt"] => string(0) ""
    }
    ["keywords"] => string(0) ""
    ["description"] => string(0) ""
    ["content"] => string(0) ""
    ["url"] => string(0) ""
    ["count"] => string(1) "0"
    ["sort"] => string(1) "0"
    ["command"] => string(1) "0"
    ["isdel"] => string(1) "0"
    ["free"] => string(1) "0"
    ["status"] => string(1) "1"
    ["uid"] => string(1) "1"
    ["username"] => string(9) "supertech"
    ["euid"] => string(1) "4"
    ["edituser"] => string(11) "system-2022"
    ["input_time"] => string(10) "1693885883"
    ["create_time"] => string(10) "1693883470"
    ["update_time"] => string(10) "1729218975"
    ["custom_code"] => string(0) ""
    ["static_title"] => string(0) ""
    ["email"] => string(18) "pv@genscigroup.com"
    ["group"] => array(2) {
      [0] => array(1) {
        ["s1gtitle"] => string(15) "地诺孕素片"
      }
      [1] => array(1) {
        ["s1gtitle"] => string(24) "盐酸托莫西汀胶囊"
      }
    }
  }
}

怀疑药品*

注射用人生长激素(赛增)
重组人生长激素注射液(赛增)
聚乙二醇重组人生长激素注射液(金赛增)
注射用重组人促卵泡激素(金赛恒)
人粒细胞刺激因子注射液(赛强)
注射用醋酸奥曲肽(金迪林)
醋酸曲普瑞林注射液
外用人粒细胞巨噬细胞刺激因子凝胶(金扶宁)
注射用醋酸西曲瑞克(金赛捷)
重组人促卵泡激素注射液(金赛恒)
醋酸甲地孕酮口服混悬液(美适亚)
黄体酮注射液(II)(金赛欣)
地诺孕素片
盐酸托莫西汀胶囊

药品上市许可持有人*

生产批号/规格*

不良反应名称
报告者信息

报告者*

报告者联系方式*

  • 医生

  • 药师

  • 患者/患者家属

  • 护士

  • 其他

验证码*

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