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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4912845 | 6089446 | I | 4912845-X | 20021101 | 20041122 | 20060113 | PER | HQWYE684124NOV04 | WYETH PHARMACEUTICALS INC. | F | N | 20051223 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4912845 | 1006939659 | PS | PREMPRO | 1 | ORAL | ORAL | D | D | 20527 | ||
| 4912845 | 1006955049 | SS | PREMARIN | 1 | D | D | |||||
| 4912845 | 1006955052 | SS | PROVERA | 1 | D | D |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 4912845 | 1006939659 | HORMONE REPLACEMENT THERAPY |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 4912845 | OT |
Reactions reported
| Event ID | PT |
|---|---|
| 4912845 | BREAST CANCER |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4912845 | CSM |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4912845 | 1006939659 | 19950101 |