If you suspect that an adverse effect / side effect has occurred due to the use of our medications, you can consult your doctor or pharmacist and fill out the form below to let us know.

In case of emergency, you can contact our Pharmacovigilance Authority by calling us at 0 216 385 93 33 or sending an email to pharmactive@deltapv.com to report the unwanted effect. 

Name and Surname of Patient
Birth date of patient (Day/Month/Year)
Gender of Patient
Name of Suspected Drug
Name of Co-Administered Other Drugs
Adverse Event and Reason for Reporting
Name and Surname of Reporter
E-mail Adress of Reporter
Phone Number of Reporter