Report Side Effect or Other Safety Information
To report a side effect or other safety information to Lundbeck, please fill in the form below. In the form, whenever the term "side effect" is used, information on other safety information can also be provided.    

Fields marked with * must be filled in. Do not provide personal information such as full name, address or social security/personal identity number when filling out the form.

In the form, you will be provided with the opportunity to fill in information on who is reporting the side effect or other safety information, the patient and type of Lundbeck medication involved, as well as details on the side effect. Information on any additional medications taken or conditions had by the patient can also be provided. 

All information reported to Lundbeck will be assessed by a patient safety employee. In some cases, Lundbeck might assess that it would be beneficial to get further information to evaluate the side effect. Providing consent for Lundbeck to contact you is fully optional.

Who is reporting the side effect?

Who experienced the side effect?

Which Lundbeck medication was the patient treated with?
Please add one medication at a time. You will have the option to fill in information for more at the bottom of the page.

Other Lundbeck drug

What side effect did the patient experience?
Please add one side effect or description of other safety information at a time. You will have the option to fill in information for more at the bottom of the page.

Was the patient taking any other type of medication?
Please add one medication at a time. You will have the option to fill in information for more at the bottom of the page.

Additional other drugs

Did the patient have any other disease(s) or condition(s)?
Please add one disease/condition at a time. You will have the option to fill in information for more at the bottom of the page.

Additional other diseases / conditions
 
* = Input is required
 
If you are reporting on behalf of another person, please enter their contact information for Lundbeck to obtain further information on the side effect, if necessary.
Select your location on the list
Please enter male or female. If you do not identify as male or female, please add your preferred descriptor.
Information on any use of Lundbeck products during pregnancy is very important for the ongoing monitoring of patient safety performed for all Lundbeck products. This applies even if the experienced side effect was unrelated to pregnancy. Please tick "Yes" if the patient was pregnant while treated with a Lundbeck product.

A specific batch or lot number is assigned to products made in the same manufacturing run and printed on each individual product package. The number allows for the individual batch of product to be traced after being released to the market. Providing the batch number helps Lundbeck ensure the quality of products on the market. You can find the batch or lot number printed on the outer packaging of the Lundbeck product next to the expiration date. The exact layout of the printing differs between packages. For examples with the batch number marked in red, see below: 




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