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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4413685 | 4187699 | I | 4413685-0 | 20040101 | 20040311 | 20040630 | PER | 04P-163-0254206-00 | PPD PHARMACOVIGILANCE | F | N | 134 | LBS | 20040311 |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4413685 | 1005069753 | PS | HUMIRA | 1 | SUBCUTANEOUS | 40 MG, 1 IN 2 WK, SUBCUTANEOUS | D | D | |||
| 4413685 | 1005095603 | C | METHOTREXATE | 1 | |||||||
| 4413685 | 1005095604 | C | QUINAPRIL HYDROCHLORIDE | 2 | |||||||
| 4413685 | 1005095608 | C | CYPROHEPTADINE HYDROCHLORIDE | 2 | |||||||
| 4413685 | 1005095611 | C | AXOTAL | 1 | |||||||
| 4413685 | 1005095612 | C | ASPIRIN | 1 | |||||||
| 4413685 | 1005095614 | C | IBUPROFEN | 1 | |||||||
| 4413685 | 1005095616 | C | MULTI-VITAMINS | 1 | |||||||
| 4413685 | 1005095617 | C | FOLIC ACID | 1 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 4413685 | 1005069753 | RHEUMATOID ARTHRITIS |
Outcome of event
| no results found |
Reactions reported
| Event ID | PT |
|---|---|
| 4413685 | DRUG INEFFECTIVE |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4413685 | CSM |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4413685 | 1005069753 | 20040101 |