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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4871960 | 5959439 | I | 4871960-X | 20051108 | 20051220 | 20051230 | EXP | T05-USA-05144-01 | FOREST LABORATORIES INC. | 87 | YR | F | N | 116 | LBS | 20051229 | OT | UNITED STATES |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4871960 | 1006786238 | PS | MEMANTINE HCL | 1 | ORAL | 4 TABLET QD PO | Y | D | 21487 | ||
| 4871960 | 1006813166 | SS | MEMANTINE HCL | 1 | ORAL | 4 TABLET QD PO | D | D | |||
| 4871960 | 1006813167 | C | NORVASC | 1 | |||||||
| 4871960 | 1006813168 | C | OSTEOBIFLEX | 2 | |||||||
| 4871960 | 1006813169 | C | PRINIVIL | 1 | |||||||
| 4871960 | 1006813170 | C | MULTI-VITAMIN | 1 | |||||||
| 4871960 | 1006813171 | C | ASPIRIN | 1 | |||||||
| 4871960 | 1006813173 | C | LIDODERM (LIDOCAINE) | 2 | |||||||
| 4871960 | 1006813176 | C | ARICEPT | 1 | |||||||
| 4871960 | 1006813177 | C | KADIAN | 1 | |||||||
| 4871960 | 1006813178 | C | PLAVIX | 1 | |||||||
| 4871960 | 1006813179 | C | DARVOCET | 1 | |||||||
| 4871960 | 1006813182 | C | SYNTHROID | 1 | |||||||
| 4871960 | 1006813184 | C | AMBIEN | 1 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 4871960 | 1006786238 | DEMENTIA ALZHEIMER'S TYPE |
| 4871960 | 1006813166 | DEMENTIA ALZHEIMER'S TYPE |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 4871960 | HO |
Reactions reported
| Event ID | PT |
|---|---|
| 4871960 | ANION GAP DECREASED |
| 4871960 | BACK PAIN |
| 4871960 | BLOOD ALBUMIN DECREASED |
| 4871960 | BLOOD CHLORIDE INCREASED |
| 4871960 | BLOOD GLUCOSE INCREASED |
| 4871960 | BLOOD POTASSIUM INCREASED |
| 4871960 | BLOOD PRESSURE DIASTOLIC INCREASED |
| 4871960 | COLD SWEAT |
| 4871960 | CONFUSIONAL STATE |
| 4871960 | DROOLING |
| 4871960 | HAEMOGLOBIN DECREASED |
| 4871960 | HYPOTENSION |
| 4871960 | LETHARGY |
| 4871960 | LOSS OF CONSCIOUSNESS |
| 4871960 | MALAISE |
| 4871960 | MENTAL STATUS CHANGES |
| 4871960 | PANCREATITIS |
| 4871960 | PCO2 DECREASED |
| 4871960 | PROTEIN TOTAL DECREASED |
| 4871960 | RENAL FAILURE ACUTE |
| 4871960 | UNRESPONSIVE TO VERBAL STIMULI |
| 4871960 | URINARY TRACT INFECTION |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4871960 | HP |
| 4871960 | SDY |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4871960 | 1006786238 | 20050823 | 20051108 | ||
| 4871960 | 1006813166 | 20051122 |