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What is Pharmacovigilance?

The WHO defines "Pharmacovigilance" as the science and activities related to the detection, evaluation, understanding, and prevention of adverse drug events or any other drug-related problems.

What is an adverse drug event?

It is any unintentional sign or symptom that a patient experiences after taking (or being treated) with a medication, in this case Lukoll's own medications or those represented in Peru.

Why should we report an adverse event related to a medication?

To contribute to updating the drug's safety profile, since this is an essential process for its safe use.

Thanks to your collaboration, Lukoll will fulfill its obligation to report information to health authorities and ensure patient safety.

If you experience any adverse events with any of Lukoll's medications, we will request the following information:

Name or initials, age, sex, information about the medication you received, as well as information about the adverse event.

If you do not wish to complete the form below, you can also contact the Lukoll Pharmacovigilance Department via:

Email: pharmacovigilancia@lukoll.com.pe

24/7 Phones: +51 997 541 287 / +51 997 541 257

At Lukoll SAC, we welcome any information regarding suspected adverse events related to the safety of our medications. Below, you will find a form for submitting such information.

Doctor Handshake Patient

ADVERSE EVENT REPORT FORM:

1. Information on adverse events related to a medication:

What is your current status?
In recovery
Recovered
Not recovered
A stranger
Did you receive treatment for the adverse event?
Yeah
No
I don't know

2. Information about the suspected drug:

What is the presentation or pharmaceutical form of the suspected medication?
Tablet
Capsule
Syrup
Injectable
Oral solution (drops)
Another formulation
Are you still taking the suspected medication?
No
Yeah
I don't know

3. Patient information:

Patient's sex
Man
Women
Was the patient pregnant at the time she took the suspect medication?
Yeah
No
I don't know

4. Reporter's data:

Personal data
I am patient
I am a health professional
Others

THE REPORTER authorizes LUKOLL SAC to use his/her information for the following purposes:

I. Contact you through any mechanism (phone, text message, email, directly or otherwise) to obtain additional information about the adverse event
Yes I accept
I do not accept
II. Transfer the personal information provided by the Reporter to its business partners (Represented Parties), as part of the reporting of adverse events related to medications.
Yes I accept
I do not accept

If the Reporter does not agree to the processing of personal data, we will use the information provided solely for purposes strictly related to the reporting of adverse drug events.

Pursuant to the foregoing, THE REPORTER expressly authorizes LUKOLL to incorporate its information into the personal data bank, as well as to store, treat, process and/or transfer its information to its business partners (Represented Parties) within the framework of information on adverse events to its own medications or those that Lukoll represents in Peru, for a period of no less than ten (10) years from the date of the adverse event report.

Without prejudice to this, the owner of the personal data may exercise their rights of access, rectification, cancellation, opposition and revocation by contacting: farmacovigilancia@lukoll.com.pe

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