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Precautions and Side Effects

Headache or sore throat may occur. If either of these effects persist or worsen, notify your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the ...
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YOUR CONTACT INFORMATION
First Name: *
Last Name: *
E-mail Address: *
Address:
City:
State: *
Zipcode:
Phone: -- xtn

CASE INFORMATION
Why Was Avandia Prescribed?: *
What Dosage, in Milligrams?:
How Frequently Was Avandia Taken?:
Date Patient Began Taking Avandia:

Stopped Taking Avandia:

What Symptoms Were Experienced?: *
Heart Attack
Stroke
Heart Failure

 Death
Other
PPH
If "Other", Please Describe:
How Long Was it From the Last Dose to the Problems Appearing?:
    Within 1 Day 2 Days 3 Days
    More Than 3 Days Don't Know
Questions/Comments:
This form is secure and encrypted. More information about secure forms and your privacy here.