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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4412692 | 4191388 | I | 4412692-1 | 20040308 | 20040317 | 20040630 | PER | 04P-163-0253899-00 | PPD PHARMACOVIGILANCE | 45 | YR | F | N | 250 | LBS | 20040317 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4412692 | 1005066469 | PS | HUMIRA | 1 | SUBCUTANEOUS | 40 MG, 1 IN 1 WK, SUBCUTANEOUS | D | D | |||
| 4412692 | 1005115908 | SS | METHOTREXATE | 1 | INTRAMUSCULAR | 25 MG, 1 IN 1 WK, INTRAMUSCULAR | D | D | |||
| 4412692 | 1005115909 | C | PREDNISONE | 1 | |||||||
| 4412692 | 1005115910 | C | HYDROXYCHLOROQUINE PHOSPHATE | 2 | |||||||
| 4412692 | 1005115911 | C | FOLIC ACID | 1 | |||||||
| 4412692 | 1005115912 | C | FOLINIC ACID | 2 | |||||||
| 4412692 | 1005115913 | C | FENTANYL | 1 | |||||||
| 4412692 | 1005115914 | C | GLIPIZIDE | 1 | |||||||
| 4412692 | 1005115915 | C | MESALAMINE | 1 | |||||||
| 4412692 | 1005115916 | C | BUDESONIDE | 2 | |||||||
| 4412692 | 1005115917 | C | LISINOPRIL | 1 | |||||||
| 4412692 | 1005115918 | C | OMEPRAZOLE | 1 | |||||||
| 4412692 | 1005115919 | C | RANITIDINE HYDROCHLORIDE | 1 | |||||||
| 4412692 | 1005115920 | C | VICODIN | 1 | |||||||
| 4412692 | 1005115921 | C | IRON | 2 | |||||||
| 4412692 | 1005115922 | C | DILTIAZEM HYDROCHLORIDE | 1 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 4412692 | 1005066469 | RHEUMATOID ARTHRITIS |
| 4412692 | 1005115908 | RHEUMATOID ARTHRITIS |
Outcome of event
| no results found |
Reactions reported
| Event ID | PT |
|---|---|
| 4412692 | ARTHRITIS |
| 4412692 | HERPES ZOSTER |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4412692 | CR |
| 4412692 | HP |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4412692 | 1005066469 | 20030101 |