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Visit our brand websites for detailed information about our products, program offerings, authorized retailers and where to buy. You’ll also find answers to frequently asked questions, full ingredient listings, patient and healthcare provider resources, and much more.

ALL PRODUCTS

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Didn’t find what you were looking for on our brand or program websites? Reach out to our Galderma Special Services team. Use the below forms to get in touch, whether you’ve experienced a side effect, need to report a product quality issue, or have other specific questions. Provide as much information as possible, including your complete contact and a specific detailed explanation of your question. For medical advice, consult with a medical doctor. In case of a medical emergency, dial 911 or visit the nearest Emergency Room.

The Company provides a hotline (available at https://galderma.integrityline.io/) to report suspected violations of Company policies or laws. Reports can be submitted anonymously and without fear of retribution.

Who are you?

Consumer or Patient

Healthcare Professional

Galderma Employee or Partner

How can we help? Select one option.

Ask a Question

Report a Side Effect

Report a Quality Issue

How can we help?

Select all that apply.

Ask a Question

Report a Side Effect

Report a Quality Issue

Please provide as many details as possible when submitting this form. Complete information helps us process your request quickly and accurately.

Please provide as many details as possible when submitting this form. Complete information helps us process your request quickly and accurately. For prescription product replacement consideration (if applicable), patient information, prescribing healthcare provider information, and lot number are mandatory.

Please provide as many details as possible when submitting this form. Complete information helps us process your request quickly and accurately. All Adverse Events should include a Reporter, the Event, a Product, and Patient identifiers (i.e. initials, gender, and age).

Please provide as many details as possible when submitting this form. Complete information helps us process your request quickly and accurately. All Product Quality Complaints should include a Reporter, the Event, and a Product, including lot number. A picture of the quality issue is also recommended.

Enter “Unknown” if the information is not known or “Not Applicable” if it does not apply. Do not enter placeholder or inaccurate information to complete required fields.

Contact

Product

First Name

Last Name

Phone

Address

City

State

Zip Code

Request Details

Galderma Employee or Partner

The person submitting the request.

Company or Organization

Company Name

Employee First Name

Employee Last Name

Employee Phone

Employee Email

Address

City

State

Zip Code

Date of Initial Receiptenter the date you were first notified of, or became aware of, the adverse event or product quality complaint.

Local Reference Number

Source of Report

Healthcare Professional

Who has prescribed the medication or is providing patient care.

Healthcare Professional First Name

Healthcare Professional Last Name

Healthcare Professional Phone

Healthcare Professional Email

Address

City

State

Zip Code

Practice Name

Healthcare Professional Credentials

Product

Request Details

Patient

The person that was treated with or used the product, or a consumer whom the question is about.

Patient First Name

Patient Last Name

Patient Phone

Patient Email

Address

City

State

Zip Code

Date of Birth

Age

Sex

Pregnant

If you are the individual notifying Galderma of this report and are not one of the parties listed above, please select.

Reporter

Reporter First Name

Reporter Last Name

Reporter Phone

Reporter Email

Reporter Relationship to Patient

Product

Side Effect

Lot Number

Expiration Date non-conforming product (i.e. expired product) shall not be used and any remaining non-conforming product shall be destroyed

How was Product Used? i.e., route of administration.

For What Medical Condition was the Product Used?

What Dose of Product was Used? i.e., quantity, e.g., milligrams, units, other amount etc.

When Did You Start the Product?

When Did You Stop the Product?

When Did the Side Effect Begin?

When Did the Side Effect End?

Did the Side Effect Resolve?

Describe the Side Effect

Product Complaint

Lot Number

Expiration Date

McKesson ID Note: This is required for aesthetic injectables.

Is Product Available for Return?

How Many Units are Defective?

Replacement is Needed Note: Patient, HCP, and Lot Number are required for prescription products.

Describe the Product Quality Complaint

Request Details

HCP Signature

Please Read: Attachment Instructions

Adverse events may be accompanied by a photo of the side effect being reported. This photo should only be shared with the consent of the patient in the photo.
Medical information requests submitted by Galderma employees on behalf of someone else must be accompanied by the signature of the requestor (in-person requests) or a copy of the interaction with the requestor (i.e., photo of email, text, etc.).
Product quality complaints must be submitted with at least one photo showing the quality issue being reported. An additional picture may be attached that shows the lot and expiration of the product.

Attach File

By providing your contact information, you consent to Galderma contacting you for the purpose of processing your inquiry. The information you submit will be used by Galderma to process to your inquiry and in accordance with Galderma’s Privacy Policy.

Upon submission of this form, you will receive a confirmation email with a case number. Email additional information received after submission to Galderma Special Services (ContactUs@GaldermaSupport.com) with the case number.

Dysport ^®(abobotulinumtoxinA) is a prescription injection for temporary improvement in the look of moderate to severe frown lines between the eyebrows (glabellar lines) in adults less than 65 years of age.

IMPORTANT SAFETY INFORMATION

What is the most important information you should know about Dysport^®? Spread of Toxin Effects: In some cases, the effects of Dysport^® and all botulinum toxin products may affect areas of the body away from the injection site. Symptoms can happen hours to weeks after injection and may include swallowing and breathing problems, loss of strength and muscle weakness all over the body, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, or loss of bladder control. Swallowing and breathing problems can be life threatening and there have been reports of death. You are at the highest risk if these problems are pre‐existing before injection.

These effects could make it unsafe for you to drive a car, operate machinery, or do other dangerous activities.

DO NOT HAVE DYSPORT^® TREATMENT IF YOU:

are allergic to Dysport® or any of its ingredients (see the end of the Medication Guide for a list of ingredients), are allergic to cow’s milk protein, had an allergic reaction to any other botulinum toxin product, such as Myobloc^®, Botox^®, or Xeomin^®, have a skin infection at the planned injection site, under 18 years of age, or are pregnant or breastfeeding.

The dose of Dysport^® is not the same as the dose of any other botulinum toxin product and cannot be compared to the dose of any other product you may have used.

TELL YOUR DOCTOR ABOUT ANY SWALLOWING OR BREATHING DIFFICULTIES AND ALL YOUR MUSCLE OR NERVE CONDITIONS

such as amyotrophic lateral sclerosis [ALS or Lou Gehrig’s disease], myasthenia gravis, or Lambert‐ Eaton syndrome, which may increase the risk of serious side effects including difficulty swallowing and difficulty breathing.

TELL YOUR DOCTOR ABOUT ANY SWALLOWING OR BREATHING DIFFICULTIES AND ALL YOUR MUSCLE OR NERVE CONDITIONS

if you have surgical changes to your face, very weak muscles in the treatment area, any abnormal facial change, injection site inflammation, droopy eyelids or sagging eyelid folds, deep facial scars, thick oily skin, wrinkles that can’t be smoothed by spreading them apart, or if you are pregnant or breastfeeding or planning to become pregnant or breastfeed.

TELL YOUR DOCTOR ABOUT ALL OF YOUR MEDICAL CONDITIONS, INCLUDING

prescription and nonprescription medicines, vitamins and herbal and other natural products. Using Dysport^® with certain other medicines may cause serious side effects. Do not start any new medicines while taking Dysport^® without talking to your doctor first.

ESPECIALLY TELL YOUR DOCTOR IF YOU:

have received any other botulinum toxin product, such as Myobloc^® (rimabotulinumtoxinB), Botox^® (onabotulinumtoxinA), or Xeomin^® (incobotulinumtoxinA), in the last four months or any in the past (be sure your doctor knows exactly which product you received, have recently received an antibiotic by injection, take muscle relaxants, take an allergy or cold medicine, or take a sleep medicine.

COMMON SIDE EFFECTS

The most common side effects are nose and throat irritation, headache, injection site pain, injection site skin reaction, upper respiratory tract infection, eyelid swelling, eyelid drooping, sinus inflammation, and nausea.

Ask your doctor if Dysport^® (abobotulinumtoxinA) is right for you.

Please see Dysport^® (abobotulinumtoxinA) Full Prescribing Information including Medication Guide.

1-866-735-4137

Monday - Friday

9:00 am - 5:00 pm CT

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