Person who experienced the adverse event (patient)
| Event ID | CASE | I F COD | FOLL SEQ | IMAGE | EVENT DT | MFR DT | FDA DT | REPT COD | MFR NUM | MFR SNDR | AGE | AGE COD | GNDR COD | E SUB | WT | WT COD | REPT DT | OCCP COD | DEATH DT | TO MFR | CONFID | REPORTER COUNTRY |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4331040 | 4054296 | F | 2 | 4331040-9 | 20030101 | 20040319 | 20040331 | EXP | US-JNJFOC-20031203060 | CENTOCOR, INC. | 63 | YR | F | N | 127 | LBS | 20040330 | MD |
Drug(s) used by person
| Event ID | DRUG SEQ | ROLE COD | DRUGNAME | VAL VBM | ROUTE | DOSE VBM | DECHAL | RECHAL | LOT NUM | EXP DT | NDA NUM |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4331040 | 1004758729 | PS | REMICADE | 1 | INTRAVENOUS | 200; 300 MG, | N | D | |||
| 4331040 | 1004768044 | C | METHOTREXATE | 1 | |||||||
| 4331040 | 1004768046 | C | WELCHOL | 1 | |||||||
| 4331040 | 1004768069 | C | SYNTHROID | 1 | |||||||
| 4331040 | 1004768070 | C | EFFEXOR | 1 | |||||||
| 4331040 | 1004768071 | C | PHENERGAN | 1 | |||||||
| 4331040 | 1004768072 | C | PREMPHASE (PROVELLA-14) | 2 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 4331040 | 1004758729 | PSORIASIS |
| 4331040 | 1004758729 | RHEUMATOID ARTHRITIS |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 4331040 | OT |
Reactions reported
| Event ID | PT |
|---|---|
| 4331040 | ANTINUCLEAR ANTIBODY POSITIVE |
| 4331040 | ASTHENIA |
| 4331040 | FATIGUE |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4331040 | HP |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4331040 | 1004758729 | 20030109 | |||
| 4331040 | 1004758729 | 20030122 | |||
| 4331040 | 1004758729 | 20030219 | |||
| 4331040 | 1004758729 | 20030417 | |||
| 4331040 | 1004758729 | 20030617 | |||
| 4331040 | 1004758729 | 20030812 | |||
| 4331040 | 1004758729 | 20040113 |