For patients, families and health care professionals
Share your story
If an inactive ingredient in a medication caused a reaction, a missed dose, or hours of phone calls for you, someone you care for, or a patient, we would like to hear about it. We use these stories to understand the problem and, with your permission, to show the FDA and lawmakers why medication labels need more detail about inactive ingredients.
- Takes about five minutes
- Only the first question is required
- You choose how it can be used
Example sentence to finish: I found out there was (an ingredient) in (a medication) when (what happened)
You could begin by finishing this sentence.
Tell us what happened
Use your own words. A few sentences is enough.
Choose how it can be used
You can keep it with our team or allow us to share it.
We contact you before sharing
We email you the exact wording first. If you do not reply, we do not use it.
This form is not for medical help or for reporting a reaction to the FDA. If someone is having a reaction right now, call 911.