Please fill in the fields as accurate as possible. It there are fields you cannot fill in, please write "unknown". Fields marked with must be filled in.
Please use the date format DD-MMM-YYYY (Example 25-FEB-2014). If you do not know the exact date, please state as close as possible (Example NOV-2014).
If you have further relevant information, please use the field 'Additional information'
NB: The products Burinex®, Centyl® K, Condyline®, Conotrane®, Fonx®, Kaleorid®, Locobase®, Mildison®, Selexid® and Synalar® have been sold to Karo Pharma A/S on April 4, 2018. LEO Pharma will therefore transfer side effects, which will be received for these products to Karo Pharma A/S.
Reporting side effects on LEO Pharma products
Report side effects by email
If you experience any side effects, please talk to your doctor, pharmacist or nurse. If you wish to report side effects regarding a LEO Pharma product via email or phone, please email: email@example.com or telephone: +44 (0) 1844 347 333 and press 2 for Medical Information.
You can also report side effects directly via the national reporting system.
For the United Kingdom, via the Yellow Card Scheme, Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
For Ireland, via HPRA Pharmacovigilance E-mail: firstname.lastname@example.org
LEO Pharma are required to record all relevant data to ensure the safety of our products. You can find more information about which data we record, your rights and how data privacy is ensured etc. on www.leo-pharma.co.uk/Home/Terms-of-use/Pharmacovigilance-Notice.aspx and www.leo-pharma.com. If you have any questions please contact us via email at email@example.com or by telephone at +44 (0) 1844 347 333 and press 2 for Medical Information.