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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5404326 | 6335752 | F | 1 | 5404326-4 | 20060925 | 20070409 | 20070713 | PER | 2007021482 | PFIZER INC | 19 | YR | F | N | 56 | KG | 20070709 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 5404326 | 1008767702 | PS | DEPO-SUBQ PROVERA 104 | 1 | SUBCUTANEOUS | 104 MG (104 MG, 1ST INJECTION), SUBCUTANEOUS | N | Y | MCO377 | 20070601 | 21583 |
| 5404326 | 1008823362 | SS | DEPO-SUBQ PROVERA 104 | 1 | SUBCUTANEOUS | 104 MG (104 MG, LAST INJECTION), SUBCUTANEOUS | MCO372 | 20070601 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 5404326 | 1008767702 | CONTRACEPTION |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 5404326 | OT |
Reactions reported
| Event ID | PT |
|---|---|
| 5404326 | INJECTION SITE REACTION |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 5404326 | HP |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 5404326 | 1008767702 | 20060925 | 20060925 | ||
| 5404326 | 1008823362 | 20061218 | 20061218 |