Person who experienced the adverse event (patient)
| Event ID | CASEID | CASEVERSION | I F COD | EVENT DT | MFR DT | INIT FDA DT | FDA DT | REPT COD | AUTH NUM | MFR NUM | MFR SNDR | LIT REF | AGE | AGE COD | AGE GRP | GNDR COD | E SUB | WT | WT COD | REPT DT | TO MFR | OCCP COD | REPORTER COUNTRY | OCCR COUNTRY |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 112174943 | 11217494 | 3 | F | 20140717 | 20160628 | 20150625 | 20160704 | EXP | CA-ROCHE-1599129 | ROCHE | 59.40 | YR | F | Y | 0.00000 | 20160704 | MD | CA | CA |
Drug(s) used by person
| Event ID | CASEID | DRUG SEQ | ROLE COD | DRUGNAME | PROD AI | VAL VBM | ROUTE | DOSE VBM | CUM DOSE CHR | CUM DOSE UNIT | DECHAL | RECHAL | LOT NUM | EXP DT | NDA NUM | DOSE AMT | DOSE UNIT | DOSE FORM | DOSE FREQ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 112174943 | 11217494 | 1 | PS | XOLAIR | OMALIZUMAB | 1 | Subcutaneous | 225 MG, BIW | U | 103976 | 225 | MG | SOLUTION FOR INJECTION | QOW | |||||
| 112174943 | 11217494 | 2 | C | ADVAIR HFA | FLUTICASONE PROPIONATESALMETEROL XINAFOATE | 1 | Unknown | U | 0 | ||||||||||
| 112174943 | 11217494 | 3 | C | VENTOLIN | ALBUTEROL SULFATE | 1 | Unknown | UNK, QD | U | 0 | QD | ||||||||
| 112174943 | 11217494 | 4 | C | VENTOLIN | ALBUTEROL SULFATE | 1 | Unknown | UNK, BID (6 WEEKS AGO) | U | 0 | BID | ||||||||
| 112174943 | 11217494 | 5 | C | NASONEX | MOMETASONE FUROATE | 1 | Unknown | U | 0 | ||||||||||
| 112174943 | 11217494 | 6 | C | SINGULAIR | MONTELUKAST SODIUM | 1 | Unknown | U | 0 | ||||||||||
| 112174943 | 11217494 | 7 | C | SYMBICORT | BUDESONIDEFORMOTEROL FUMARATE DIHYDRATE | 1 | Unknown | 2 DF (2 PUFFS), BID | U | 0 | 2 | DF | BID |
Indications of drugs used
| Event ID | CASEID | INDI DRUG SEQ | INDI PT |
|---|---|---|---|
| 112174943 | 11217494 | 1 | Asthma |
| 112174943 | 11217494 | 2 | Product used for unknown indication |
| 112174943 | 11217494 | 3 | Product used for unknown indication |
| 112174943 | 11217494 | 5 | Product used for unknown indication |
| 112174943 | 11217494 | 6 | Product used for unknown indication |
| 112174943 | 11217494 | 7 | Product used for unknown indication |
Outcome of event
| Event ID | CASEID | OUTC COD |
|---|---|---|
| 112174943 | 11217494 | HO |
Reactions reported
| Event ID | CASEID | DRUG REC ACT | PT |
|---|---|---|---|
| 112174943 | 11217494 | Asthma | |
| 112174943 | 11217494 | Drug ineffective | |
| 112174943 | 11217494 | Nasopharyngitis | |
| 112174943 | 11217494 | Pain in extremity |
Reporting Sources (this data is often not reported and may therefore be missing here)
| no results found |
Therapies reported
| Event ID | CASEID | DSG DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|---|
| 112174943 | 11217494 | 1 | 20140717 | 0 |