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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5041732 | 5821946 | F | 1 | 5041732-4 | 20050530 | 20060627 | 20060630 | EXP | HQWYE137402JUN05 | WYETH CONSUMER HEALTHCARE | 78 | YR | F | N | 72.64 | KG | 20060628 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 5041732 | 1007435641 | PS | AXID AR | 1 | ORAL | 1 TABLET 1X PER 1 DAY, ORAL | Y | D | 20555 | ||
| 5041732 | 1007457385 | C | XANAX | 1 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 5041732 | 1007435641 | GASTROOESOPHAGEAL REFLUX DISEASE |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 5041732 | OT |
Reactions reported
| Event ID | PT |
|---|---|
| 5041732 | DIZZINESS |
| 5041732 | DRUG INEFFECTIVE |
| 5041732 | GINGIVAL SWELLING |
| 5041732 | OEDEMA MOUTH |
| 5041732 | SWELLING FACE |
| 5041732 | THROAT TIGHTNESS |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 5041732 | CSM |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 5041732 | 1007435641 | 20050530 | 20050530 |