Adverse Drug Reaction (ADR) Reporting

1.What is an adverse reaction?

An adverse drug reaction (ADR) refers to a noxious response to an approved drug that occurs at normal doses during proper use and is not related to the drug’s intended therapeutic purpose. An ADR is not equivalent to a quality issue with the drug.
2.Why are adverse events being reported?

GenSci has established multiple channels to continuously monitor the safety of our products. By reporting adverse events/reactions related to GenSci products, you contribute to our ongoing effort to refine our product safety features and ensure patient medication safety.
3.How to report an adverse event?

If you experience an adverse event, you should consult a doctor promptly. Please complete the adverse event/reaction reporting form and you may also report adverse events/reactions by calling the hotline provided in the package insert. Thank you for reporting the adverse events/reactions! We wish you and your family good health!
4.Privacy Statement

GenSci will adhere to privacy laws and ensure the confidentiality of you and the information you provide. Please be rest assured when providing your information!

Patient Information

Name*

Gender*

Male

Female

Date of Birth*

Province*

Prescription Hospital*

Reason for Medication*

Suspected Drug Information

array(2) {
  [0] => array(25) {
    ["id"] => string(1) "2"
    ["catid"] => string(3) "121"
    ["title"] => string(36) "沙巴体育"
    ["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) "1729219052"
    ["custom_code"] => string(0) ""
    ["static_title"] => string(0) ""
    ["email"] => string(19) "adr@genscigroup.com"
    ["group"] => array(12) {
      [0] => array(1) {
        ["s1gtitle"] => string(49) "Human Growth Hormone for injection（Jintropin）"
      }
      [1] => array(1) {
        ["s1gtitle"] => string(57) "Recombinant Human Growth Hormone Injection（Jintropin）"
      }
      [2] => array(1) {
        ["s1gtitle"] => string(78) "Polyethylene Glycol Recombinant Human Growth Hormone Injection（Jintrolong）"
      }
      [3] => array(1) {
        ["s1gtitle"] => string(43) "Recombinant Human Follitropin for injection"
      }
      [4] => array(1) {
        ["s1gtitle"] => string(65) "Human Granulocyte Colony-Stimulating Factor injection（Scimax）"
      }
      [5] => array(1) {
        ["s1gtitle"] => string(48) "Octreotide Acetate for injection（Jintrotide）"
      }
      [6] => array(1) {
        ["s1gtitle"] => string(29) "Triptorelin Acetate injection"
      }
      [7] => array(1) {
        ["s1gtitle"] => string(75) "Human Granulocyte/Macrophage Colony-stimulating Factor Gel for External Use"
      }
      [8] => array(1) {
        ["s1gtitle"] => string(39) "Cetrorelix Acetate Powder for Injection"
      }
      [9] => array(1) {
        ["s1gtitle"] => string(39) "Recombinant Human Follitropin Injection"
      }
      [10] => array(1) {
        ["s1gtitle"] => string(33) "Megestrol Acetate Oral Suspension"
      }
      [11] => array(1) {
        ["s1gtitle"] => string(26) "Progesterone Injection(II)"
      }
    }
  }
  [1] => array(25) {
    ["id"] => string(1) "1"
    ["catid"] => string(3) "121"
    ["title"] => string(39) "北京沙巴体育增医疗科技有限沙巴体育"
    ["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) "1729219065"
    ["custom_code"] => string(0) ""
    ["static_title"] => string(0) ""
    ["email"] => string(18) "pv@genscigroup.com"
    ["group"] => array(2) {
      [0] => array(1) {
        ["s1gtitle"] => string(17) "Dienogest Tablets"
      }
      [1] => array(1) {
        ["s1gtitle"] => string(34) "Atomoxetine Hydrochloride Capsules"
      }
    }
  }
}

Suspected Drug*

Human Growth Hormone for injection（Jintropin）

Recombinant Human Growth Hormone Injection（Jintropin）

Polyethylene Glycol Recombinant Human Growth Hormone Injection（Jintrolong）

Recombinant Human Follitropin for injection

Human Granulocyte Colony-Stimulating Factor injection（Scimax）

Octreotide Acetate for injection（Jintrotide）

Triptorelin Acetate injection

Human Granulocyte/Macrophage Colony-stimulating Factor Gel for External Use

Cetrorelix Acetate Powder for Injection

Recombinant Human Follitropin Injection

Megestrol Acetate Oral Suspension

Progesterone Injection(II)

Dienogest Tablets

Atomoxetine Hydrochloride Capsules

Drug Marketing Authorization Holder*

Batch Number/Strength*

Name of Adverse Reaction

Reporter Information

Reporter*

Reporter Contact Information*

Doctor
Pharmacist
Patient/Patient’s Family
Nurse
Other

Verification Code*

I have read and agree to GenSci’s Privacy Policy

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