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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4465977 | 5664780 | I | 4465977-7 | 20040920 | 20040930 | EXP | STA-AE-04-MTX-426 | STADA PHARMACEUTICALS, INC. | 63 | YR | F | N | 20040920 | OT |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4465977 | 1005265064 | PS | METHOTREXATE | 1 | ORAL | 7.5 MG, ORAL | D | D | 8085 | ||
| 4465977 | 1005287330 | C | ASPIRIN | 1 | |||||||
| 4465977 | 1005287331 | C | FUROSEMIDE | 1 | |||||||
| 4465977 | 1005287332 | C | METOPROLOL TARTRATE | 1 | |||||||
| 4465977 | 1005287334 | C | SIMVASTATIN | 1 | |||||||
| 4465977 | 1005287335 | C | RAMIPRIL | 1 | |||||||
| 4465977 | 1005287336 | C | ROFECOXIB | 1 | |||||||
| 4465977 | 1005287337 | C | ACYCLOVIR | 1 | |||||||
| 4465977 | 1005287338 | C | AMOXICILLIN | 1 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 4465977 | 1005265064 | RHEUMATOID ARTHRITIS |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 4465977 | DE |
Reactions reported
| Event ID | PT |
|---|---|
| 4465977 | CARDIAC FAILURE |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4465977 | DT |
| 4465977 | FGN |
| 4465977 | HP |
| 4465977 | OTH |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4465977 | 1005265064 | 20040506 |