Report a side effect

Report a side 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.

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. 

Reporter information

Name

This information is required

Location*

This information is required

Please enter the location*

This information is required

Healthcare Professional type

This information is required

Information about the person who experienced the side effect

Who experienced the side effects?

This information is required

Age at the time of the side effect

This information is required

Gender

This information is required

Location

This information is required

Please enter the location*

This information is required

Information about the medicine

Add all Novo Nordisk suspect products

Please list the Novo Nordisk product(s) which you suspect could have caused the side effect(s). You can add more than one suspect Novo Nordisk product, if needed. Simply click 'add suspect product'.
{{ numberToText(Number(index) + 1) }} suspect product
Remove

Name of the product*

This information is required

The product batch/LOT number

The batch/LOT number is printed on the packaging of the medicine and on the product. If you do not have the number, leave the field empty.

On which date did you start taking the product?

On which date did you stop taking the product?

Product dosage and frequency

Describe the condition for which the product was taken

Add another suspect product +

Side effect description

Please list the side effect(s) which you would like to report. You can report more than one side effect, if needed. Simply click 'add side effect'.
{{ numberToText(Number(index) + 1) }} side effect
Remove

Side effect*

This information is required

Please describe details of the side effect experienced

This information is required

Start date of the side effect

Stop date of the side effect

Add another side effect +

Consent and data privacy

Notice of personal data processing*

This information is required This information is required

May Novo Nordisk contact you for further information, if needed, and may Novo Nordisk retain your personal information in our overseas database (for safety reporting purposes only)?*

This information is required

Phone number

E-mail*

This information is required

Confirm email*

This information is required

May Novo Nordisk contact your doctor for further information, if needed?

Doctor's name

Doctor's phone number

Doctor's email*

This information is required

Confirm doctor's email*

This information is required
reCAPTCHA verification required
Something went wrong. Unfortunately, your form could not be sent because we are missing some necessary information. The fields that require your input are marked above.

If you have experienced a side effect to a Novo Nordisk product, we encourage you to also report this to Novo Nordisk. 

Or you can visit novonordisk.com and use our dedicated reporting form. Here we will ask you for the most important information needed when reporting side effects.

Go to novonordisk.com to report side effects