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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 125199672 | 12519967 | 2 | F | 20160531 | 20160705 | 20160701 | 20160708 | EXP | FR-ROCHE-1784676 | ROCHE | 33.00 | YR | M | Y | 0.00000 | 20160708 | MD | FR | FR |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 125199672 | 12519967 | 1 | PS | VALIUM | DIAZEPAM | 1 | Oral | 20 TABLETS | U | 13263 | 200 | MG | TABLET | ||||||
| 125199672 | 12519967 | 2 | SS | Midazolam Maleate | MIDAZOLAM MALEATE | 1 | Oral | U | 0 | 10 | DF | TABLET | |||||||
| 125199672 | 12519967 | 3 | SS | Amitriptyline | AMITRIPTYLINE | 1 | Oral | 40 TABLETS | U | 0 | 40 | DF | TABLET | ||||||
| 125199672 | 12519967 | 4 | SS | TERCIAN | CYAMEMAZINE | 1 | Oral | 3 TABLETS | U | 0 | 45 | MG | TABLET | ||||||
| 125199672 | 12519967 | 5 | SS | POLARAMINE | DEXCHLORPHENIRAMINE MALEATE | 1 | Oral | U | 0 | 40 | MG | TABLET |
Indications of drugs used
| Event ID | CASEID | INDI DRUG SEQ | INDI PT |
|---|---|---|---|
| 125199672 | 12519967 | 1 | Product used for unknown indication |
| 125199672 | 12519967 | 2 | Product used for unknown indication |
| 125199672 | 12519967 | 3 | Product used for unknown indication |
| 125199672 | 12519967 | 4 | Product used for unknown indication |
| 125199672 | 12519967 | 5 | Product used for unknown indication |
Outcome of event
| Event ID | CASEID | OUTC COD |
|---|---|---|
| 125199672 | 12519967 | HO |
Reactions reported
| Event ID | CASEID | DRUG REC ACT | PT |
|---|---|---|---|
| 125199672 | 12519967 | Altered state of consciousness | |
| 125199672 | 12519967 | Aspiration | |
| 125199672 | 12519967 | Coma | |
| 125199672 | 12519967 | Hypoxia | |
| 125199672 | 12519967 | Respiratory distress | |
| 125199672 | 12519967 | Vomiting |
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 |
|---|---|---|---|---|---|---|
| 125199672 | 12519967 | 1 | 20160531 | 20160531 | 0 | |
| 125199672 | 12519967 | 2 | 20160531 | 20160531 | 0 | |
| 125199672 | 12519967 | 3 | 20160531 | 20160531 | 0 | |
| 125199672 | 12519967 | 4 | 20160531 | 20160531 | 0 | |
| 125199672 | 12519967 | 5 | 20160531 | 20160531 | 0 |