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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 125557821 | 12555782 | 1 | I | 20160526 | 0 | 20160713 | 20160713 | DIR | 61.00 | YR | F | N | 0.00000 | 20160712 | N | MD | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 125557821 | 12555782 | 1 | PS | COPAXONE | GLATIRAMER ACETATE | 1 | Subcutaneous | D | D | 0 | 40 | MG | TIW | ||||||
| 125557821 | 12555782 | 3 | C | CLONAZEPAM. | CLONAZEPAM | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 5 | C | COLACE | DOCUSATE SODIUM | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 7 | C | ESTRADIOL. | ESTRADIOL | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 9 | C | FENTANYL. | FENTANYL | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 11 | C | ADVAIR DISKUS | FLUTICASONE PROPIONATESALMETEROL XINAFOATE | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 13 | C | LORATADINE. | LORATADINE | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 15 | C | ACETAMINOPHENHYDROCODONE BITARTRATE | ACETAMINOPHENHYDROCODONE BITARTRATE | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 17 | C | CONCERTA | METHYLPHENIDATE HYDROCHLORIDE | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 19 | C | MULTIVITAMIN | VITAMINS | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 21 | C | FIBER FORMULA SUPPLEMENT | 2 | 0 | |||||||||||||
| 125557821 | 12555782 | 23 | C | FISH OIL | FISH OIL | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 25 | C | PROMETRIUM | PROGESTERONE | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 27 | C | VENTOLIN | ALBUTEROL SULFATE | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 29 | C | VITAMIN B12 | CYANOCOBALAMIN | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 31 | C | VITAMIN D3 | CHOLECALCIFEROL | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 33 | C | FLUOXETINE | FLUOXETINE HYDROCHLORIDE | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 35 | C | LAMICTAL | LAMOTRIGINE | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 37 | C | LYRICA | PREGABALIN | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 39 | C | PROZAC | FLUOXETINE HYDROCHLORIDE | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 41 | C | KEPPRA | LEVETIRACETAM | 1 | 0 | ||||||||||||
| 125557821 | 12555782 | 43 | C | BACLOPHEN | 2 | 0 | |||||||||||||
| 125557821 | 12555782 | 45 | C | KETAMINE/GABAPENTIN/CLONIDINE CREAM | 2 | 0 |
Indications of drugs used
| Event ID | CASEID | INDI DRUG SEQ | INDI PT |
|---|---|---|---|
| 125557821 | 12555782 | 1 | Multiple sclerosis |
Outcome of event
| Event ID | CASEID | OUTC COD |
|---|---|---|
| 125557821 | 12555782 | OT |
Reactions reported
| Event ID | CASEID | DRUG REC ACT | PT |
|---|---|---|---|
| 125557821 | 12555782 | Drug dose omission | |
| 125557821 | 12555782 | Neoplasm malignant |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | CASEID | RPSR COD |
|---|---|---|
| 125557821 | 12555782 | HP |
Therapies reported
| Event ID | CASEID | DSG DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|---|
| 125557821 | 12555782 | 1 | 20130124 | 0 |