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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5041730 | 6080360 | I | 5041730-0 | 20060401 | 20060621 | 20060630 | EXP | HQWYE339822JUN06 | WYETH PHARMACEUTICALS INC. | 13 | YR | F | N | 20060629 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 5041730 | 1007435634 | PS | PREMARIN | 1 | ORAL | 0.625 MG 1X PER 1 DAY, ORAL | D | D | 4782 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 5041730 | 1007435634 | OESTROGEN REPLACEMENT THERAPY |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 5041730 | HO |
Reactions reported
| Event ID | PT |
|---|---|
| 5041730 | ABDOMINAL DISTENSION |
| 5041730 | BLOOD ALBUMIN DECREASED |
| 5041730 | OEDEMA PERIPHERAL |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 5041730 | CSM |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 5041730 | 1007435634 | 20041201 | 20060529 |