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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 121036914 | 12103691 | 4 | F | 20141107 | 20160812 | 20160223 | 20160817 | EXP | CA-ROCHE-1626967 | ROCHE | 53.64 | YR | F | Y | 0.00000 | 20160817 | CN | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 121036914 | 12103691 | 1 | PS | XOLAIR | OMALIZUMAB | 1 | Subcutaneous | POWDER AND SOLVENT FOR SOLUTION FOR INJECTION | U | S0058A,S003B | 103976 | 300 | MG | SOLUTION FOR INJECTION | QOW | ||||
| 121036914 | 12103691 | 2 | SS | XOLAIR | OMALIZUMAB | 1 | Subcutaneous | POWDER AND SOLVENT FOR SOLUTION FOR INJECTION | U | S0058A,S003B | 103976 | SOLUTION FOR INJECTION | |||||||
| 121036914 | 12103691 | 3 | C | ZENHALE | FORMOTEROL FUMARATEMOMETASONE FUROATE | 1 | Unknown | U | 0 | ||||||||||
| 121036914 | 12103691 | 4 | C | SINGULAIR | MONTELUKAST SODIUM | 1 | Unknown | U | 0 | ||||||||||
| 121036914 | 12103691 | 5 | C | VENTOLIN | ALBUTEROL SULFATE | 1 | Unknown | U | 0 | ||||||||||
| 121036914 | 12103691 | 6 | C | ALVESCO | CICLESONIDE | 1 | Unknown | U | 0 |
Indications of drugs used
| Event ID | CASEID | INDI DRUG SEQ | INDI PT |
|---|---|---|---|
| 121036914 | 12103691 | 1 | Asthma |
| 121036914 | 12103691 | 3 | Product used for unknown indication |
| 121036914 | 12103691 | 4 | Product used for unknown indication |
| 121036914 | 12103691 | 5 | Product used for unknown indication |
| 121036914 | 12103691 | 6 | Product used for unknown indication |
Outcome of event
| Event ID | CASEID | OUTC COD |
|---|---|---|
| 121036914 | 12103691 | OT |
Reactions reported
| Event ID | CASEID | DRUG REC ACT | PT |
|---|---|---|---|
| 121036914 | 12103691 | Basal cell carcinoma | |
| 121036914 | 12103691 | Blood pressure increased | |
| 121036914 | 12103691 | Fall | |
| 121036914 | 12103691 | Fractured coccyx | |
| 121036914 | 12103691 | Nasal congestion | |
| 121036914 | 12103691 | Pain | |
| 121036914 | 12103691 | Sneezing |
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 |
|---|---|---|---|---|---|---|
| 121036914 | 12103691 | 1 | 20140408 | 0 | ||
| 121036914 | 12103691 | 2 | 20160729 | 0 |