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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4411305 | 5741865 | I | 4411305-2 | 20040513 | 20040719 | 20040727 | EXP | HQWYE259120JUL04 | WYETH LABS (RA) | 65 | YR | M | N | 20040726 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4411305 | 1005060910 | PS | PROPRANOLOL HYDROCHLORIDE | 1 | ORAL | 160 MG 1X PER 1 DAY ORAL | D | D | 16418 | ||
| 4411305 | 1005082249 | SS | CREON | 1 | D | D | |||||
| 4411305 | 1005082250 | SS | LACTEOL (LACTOBACILUS ACIDOPHILUS,) | 2 | D | D | |||||
| 4411305 | 1005082257 | SS | LOPERAMIDE HCL | 1 | 1 DOSE 1X PER 1 DAY | D | D | ||||
| 4411305 | 1005082258 | SS | NOOTROPYL (PIRACETAM,) | 2 | 2.4 G 1X PER 1 DAY | D | D | ||||
| 4411305 | 1005082259 | C | TIORFAN (ACETORPHAN,) | 2 | 100 MG 1X PER 1 DAY | D | D | ||||
| 4411305 | 1005082260 | SS | VAGOSTABYL (CALCIUM LACTATE/CRATAEGUS/MAGNESIUM THIOSULFATE/MELISSA EX | 2 | 3 DOSE 1X PER 1 DAY | D | D |
Indications of drugs used
| no results found |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 4411305 | HO |
Reactions reported
| Event ID | PT |
|---|---|
| 4411305 | HEPATITIS |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4411305 | FGN |
| 4411305 | HP |
| 4411305 | OTH |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4411305 | 1005060910 | 20000101 | |||
| 4411305 | 1005082249 | 20040401 | |||
| 4411305 | 1005082250 | 20040401 | |||
| 4411305 | 1005082257 | 20040403 | 20040415 | 13 | DAY |
| 4411305 | 1005082258 | 20000101 | 20040529 | 1611 | DAY |
| 4411305 | 1005082259 | 20040415 | 20040529 | 45 | DAY |
| 4411305 | 1005082260 | 20040403 | 20040529 | 57 | DAY |