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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 122664355 | 12266435 | 5 | F | 20160913 | 20160414 | 20160913 | EXP | US-ALLERGAN-1653379US | ALLERGAN | 62.00 | YR | F | Y | 0.00000 | 20160913 | CN | US | US |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 122664355 | 12266435 | 1 | PS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 10 UNITS, SINGLE | C3900 | 103000 | POWDER FOR INJECTION | QD | |||||||
| 122664355 | 12266435 | 2 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 10 UNITS, SINGLE | 103000 | POWDER FOR INJECTION | QD | ||||||||
| 122664355 | 12266435 | 3 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 30 UNITS, SINGLE | 103000 | POWDER FOR INJECTION | QD | ||||||||
| 122664355 | 12266435 | 4 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 20 UNITS, SINGLE | 103000 | POWDER FOR INJECTION | QD | ||||||||
| 122664355 | 12266435 | 5 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 30 UNITS, SINGLE | 103000 | POWDER FOR INJECTION | QD | ||||||||
| 122664355 | 12266435 | 6 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 40 UNITS, SINGLE | 103000 | POWDER FOR INJECTION | QD | ||||||||
| 122664355 | 12266435 | 7 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 10 UNITS, SINGLE | C3824 | 103000 | POWDER FOR INJECTION | QD | |||||||
| 122664355 | 12266435 | 8 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 10 UNITS, SINGLE | 103000 | POWDER FOR INJECTION | QD | ||||||||
| 122664355 | 12266435 | 9 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 30 UNITS, SINGLE | 103000 | POWDER FOR INJECTION | QD | ||||||||
| 122664355 | 12266435 | 10 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 20 UNITS, SINGLE | 103000 | POWDER FOR INJECTION | QD | ||||||||
| 122664355 | 12266435 | 11 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 30 UNITS, SINGLE | 103000 | POWDER FOR INJECTION | QD | ||||||||
| 122664355 | 12266435 | 12 | SS | BOTOX | ONABOTULINUMTOXINA | 1 | Intramuscular | 40 UNITS, SINGLE | 103000 | POWDER FOR INJECTION | QD | ||||||||
| 122664355 | 12266435 | 13 | C | LORAZEPAM. | LORAZEPAM | 1 | U | 0 | |||||||||||
| 122664355 | 12266435 | 14 | C | FLEXERIL | CYCLOBENZAPRINE HYDROCHLORIDE | 1 | PRN QHS | U | 0 | .5 | MG | ||||||||
| 122664355 | 12266435 | 15 | C | PHENERGAN | PROMETHAZINE HYDROCHLORIDE | 1 | UNK UNK, PRN | U | 0 | ||||||||||
| 122664355 | 12266435 | 16 | C | FROVA | FROVATRIPTAN SUCCINATE | 1 | U | 0 | |||||||||||
| 122664355 | 12266435 | 17 | C | MAXALT | RIZATRIPTAN BENZOATE | 1 | UNK UNK, PRN | U | 0 |
Indications of drugs used
| Event ID | CASEID | INDI DRUG SEQ | INDI PT |
|---|---|---|---|
| 122664355 | 12266435 | 1 | Migraine |
| 122664355 | 12266435 | 13 | Anxiety |
| 122664355 | 12266435 | 14 | Product used for unknown indication |
| 122664355 | 12266435 | 15 | Product used for unknown indication |
| 122664355 | 12266435 | 16 | Product used for unknown indication |
| 122664355 | 12266435 | 17 | Product used for unknown indication |
Outcome of event
| Event ID | CASEID | OUTC COD |
|---|---|---|
| 122664355 | 12266435 | OT |
| 122664355 | 12266435 | HO |
Reactions reported
| Event ID | CASEID | DRUG REC ACT | PT |
|---|---|---|---|
| 122664355 | 12266435 | Anxiety | |
| 122664355 | 12266435 | Rib fracture |
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 |
|---|---|---|---|---|---|---|
| 122664355 | 12266435 | 1 | 20160114 | 20160114 | 0 | |
| 122664355 | 12266435 | 2 | 20160114 | 20160114 | 0 | |
| 122664355 | 12266435 | 3 | 20160114 | 20160114 | 0 | |
| 122664355 | 12266435 | 4 | 20160114 | 20160114 | 0 | |
| 122664355 | 12266435 | 5 | 20160114 | 20160114 | 0 | |
| 122664355 | 12266435 | 6 | 20160114 | 20160114 | 0 | |
| 122664355 | 12266435 | 7 | 20151008 | 20151008 | 0 | |
| 122664355 | 12266435 | 8 | 20151008 | 20151008 | 0 | |
| 122664355 | 12266435 | 9 | 20151008 | 20151008 | 0 | |
| 122664355 | 12266435 | 10 | 20151008 | 20151008 | 0 | |
| 122664355 | 12266435 | 11 | 20151008 | 20151008 | 0 | |
| 122664355 | 12266435 | 12 | 20151008 | 20151008 | 0 |