Drug Adverse Report

Drug Adverse Report ID:10772057

Responsible use of the data

Adverse event reports submitted to FDA do not undergo extensive validation or verification. Therefore, a causal relationship cannot be established between product and reactions listed in a report. While a suspected relationship may exist, it is not medically validated and should not be the sole source of information for clinical decision making or other assumptions about the safety or efficacy of a product.

Additionally, it is important to remember that adverse event reports represent a small percentage of total usage numbers of a product. Common products may have a higher number of adverse events due to the higher total number of people using the product. In recent years the FDA has undertaken efforts to increase collection of adverse events. Increases in the total number of adverse events is likely caused by improved reporting.

Disclaimer

FAERS data does have limitations. There is no certainty that the reported event (adverse event or medication error) was actually due to the product. FDA does not require that a causal relationship between a product and event be proven, and reports do not always contain enough detail to properly evaluate an event.

Further, FDA does not receive reports for every adverse event or medication error that occurs with a product. Many factors can influence whether or not an event will be reported, such as the time a product has been marketed and publicity about an event.

Submission of a safety report does not constitute an admission that medical personnel, user facility, importer, distributor, manufacturer or product caused or contributed to the event. The information in these reports has not been scientifically or otherwise verified as to a cause and effect relationship and cannot be used to estimate the incidence of these events.

Drug Adverse Report

Safety Report ID 10772057
The 8-digit Safety Report ID number, also known as the case report number or case ID. The first 7 digits (before the hyphen) identify an individual report and the last digit (after the hyphen) is a checksum. This field can be used to identify or find a specific adverse event report.
Receive Date 02/06/2015
Date that the report was first received by FDA. If this report has multiple versions, this will be the date the first version was received by FDA.
Occur Country US
The name of the country where the event occurred.

Patient Information

Patient Sex Female
The sex of the patient:
  • Unknown
  • Male
  • Female
Patient Age 57
Age of the patient when the event first occured.
Patient Age Unit Year
The unit for the interval in the field 'patientage'.
  • Decade
  • Year
  • Month
  • Week
  • Day
  • Hour
Patient Age Group N/S (not specified)
Populated with Patient Age Group code:
  • Neonate
  • Infant
  • Child
  • Adolescent
  • Adult
  • Elderly
Patient Weight 58.5
The patient weight, in kg (kilograms).

Patient Reaction(s)

# Reaction MedDRA Reaction Outcome
1 Gait disturbance Not recovered/not resolved
2 Therapy cessation Unknown
3 Therapeutic response unexpected Unknown
4 Paraesthesia Not recovered/not resolved
5 Peripheral swelling Not recovered/not resolved
6 Multiple sclerosis relapse Not recovered/not resolved
7 Therapy cessation Recovered/resolved
8 Hypoaesthesia Not recovered/not resolved
9 Peroneal nerve palsy Not recovered/not resolved

Drug #1

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Concomitant”
The drug was reported as being taken along with the suspect drug.
Manufacturer Name Product NDC Package NDC
Medicinal Product GARLIC
  • Allergy Laboratories, Inc.
  • Antigen Laboratories, Inc.
  • Boiron
  • Natural Health Supply
  • Nelco Laboratories, Inc.
  • Washington Homeopathic Products
  • 0220-0177
  • 36987-1282
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  • 54575-932
  • 54575-933
  • 54575-935
  • 54575-936
  • 54575-937
  • 54575-938
  • 54575-939
  • 54575-940
  • 54575-941
  • 54575-943
  • 54575-944
  • 54575-945
  • 54575-946
  • 54575-947
  • 54575-948
  • 54575-949
  • 54575-950
  • 54575-951
  • 54575-952
  • 54575-953
  • 54575-954
  • 54575-955
  • 54575-956
  • 54575-957
  • 54575-958
  • 54575-959
  • 54575-960
  • 54575-962
  • 54575-963
  • 54575-964
  • 54575-965
  • 54575-966
  • 54575-967
  • 54575-968
  • 54575-969
  • 54575-970
  • 54575-971
  • 54575-972
  • 54575-973
  • 54575-974
  • 54575-978
  • 64117-643
  • 68428-189
  • 71919-029
  • 49288-0480
Generic Name GARLIC
Brand Name
GARLIC, ALLIUM SATIVUM, NHS HIP PAIN
Active Substance Name GARLIC
Drug Indication Product used for unknown indication
Drug Administration Route Unknown

Drug #2

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Concomitant”
The drug was reported as being taken along with the suspect drug.
Manufacturer Name Product NDC Package NDC
Medicinal Product BACLOFEN
  • Cadila Healthcare Limited
  • Emerald International Limited
  • Lannett Company, Inc.
  • Mallinckrodt Inc (Brand Pharmaceuticals)
  • Marlex Pharmaceuticals Inc
  • Medtronic Neuromodulation
  • Mylan Institutional LLC
  • New Horizon Rx Group, LLC
  • Northstar RxLLC
  • Par Pharmaceutical
  • Saol Therapeutics Inc.
  • Teva Pharmaceuticals USA, Inc.
  • TruPharma LLC
  • Upsher-Smith Laboratories, LLC
  • Zydus Pharmaceuticals (USA) Inc.
  • 0172-4096
  • 0172-4097
  • 0527-1330
  • 0527-1337
  • 0603-2406
  • 0603-2407
  • 0832-1024
  • 0832-1025
  • 0832-1054
  • 0832-1055
  • 10135-532
  • 10135-533
  • 16714-071
  • 16714-072
  • 45945-151
  • 45945-155
  • 45945-156
  • 45945-157
  • 52817-319
  • 52817-320
  • 52817-321
  • 58281-560
  • 58281-561
  • 58281-562
  • 58281-563
  • 67457-562
  • 67457-563
  • 67457-564
  • 70257-560
  • 70257-561
  • 70257-562
  • 70257-563
  • 70710-1285
  • 70710-1286
  • 70771-1448
  • 70771-1449
  • 71525-005
  • 71525-010
  • 71525-040
  • 58517-440
Generic Name BACLOFEN
Brand Name
GABLOFEN, LIORESAL, BACLOFEN, LIORESAL (BACLOFEN), BACLOFEN (INTRATHECAL)
Active Substance Name BACLOFEN
Drug Indication Product used for unknown indication
Drug Administration Route Unknown

Drug #3

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Concomitant”
The drug was reported as being taken along with the suspect drug.
Manufacturer Name Product NDC Package NDC
Medicinal Product ALL OTHER THERAPEUTIC PRODUCTS
Generic Name
Brand Name
Active Substance Name UNSPECIFIED INGREDIENT
Drug Indication Bladder disorder
Drug Administration Route

Drug #4

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Suspect”
The drug was considered by the reporter to be the cause.
Manufacturer Name Product NDC Package NDC
Medicinal Product AMPYRA
  • Acorda Therapeutics, Inc.
  • 10144-427
Generic Name DALFAMPRIDINE
Brand Name
AMPYRA
Active Substance Name DALFAMPRIDINE
Drug Indication
Drug Administration Route Oral

Drug #5

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Concomitant”
The drug was reported as being taken along with the suspect drug.
Manufacturer Name Product NDC Package NDC
Medicinal Product TYSABRI
  • Biogen Inc.
  • 64406-008
Generic Name NATALIZUMAB
Brand Name
TYSABRI
Active Substance Name NATALIZUMAB
Drug Indication Product used for unknown indication
Drug Administration Route Intravenous (not otherwise specified)

Drug #6

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Concomitant”
The drug was reported as being taken along with the suspect drug.
Manufacturer Name Product NDC Package NDC
Medicinal Product CITALOPRAM
  • Allergan, Inc.
  • Amneal Pharmaceuticals LLC
  • Aurobindo Pharma Limited
  • Aurolife Pharma LLC
  • Camber Pharmaceuticals
  • Cipla USA Inc.
  • Eon Labs, Inc.
  • Epic Pharma, LLC
  • Exelan Pharmaceuticals Inc.
  • G&W Laboratories, Inc.
  • International Laboratories, LLC
  • Jubilant Cadista Pharmaceuticals Inc.
  • Mylan Pharmaceuticals Inc.
  • New Horizon Rx Group, LLC
  • West-Ward Pharmaceuticals Corp
  • 0054-0062
  • 0185-0371
  • 0185-0372
  • 0185-0373
  • 0378-6231
  • 0378-6232
  • 0378-6233
  • 0456-4010
  • 0456-4040
  • 0713-4740
  • 0713-4741
  • 0713-4742
  • 13107-005
  • 13107-006
  • 13107-007
  • 31722-206
  • 31722-207
  • 31722-208
  • 42806-019
  • 42806-020
  • 42806-021
  • 54458-889
  • 54458-980
  • 54458-981
  • 58517-100
  • 59746-543
  • 59746-544
  • 59746-546
  • 65162-052
  • 65162-053
  • 65162-054
  • 65862-005
  • 65862-006
  • 65862-007
  • 69097-822
  • 69097-823
  • 69097-824
  • 76282-206
  • 76282-207
  • 76282-208
  • 76282-628
  • 76282-629
  • 0456-4020
Generic Name CITALOPRAM, CITALOPRAM TABLETS, CITALOPRAM TABLET, CITALOPRAM HYDROBROMIDE
Brand Name
CITALOPRAM, CELEXA, CITALOPRAM HYDROBROMIDE
Active Substance Name CITALOPRAM HYDROBROMIDE
Drug Indication Product used for unknown indication
Drug Administration Route Unknown

Drug #7

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Concomitant”
The drug was reported as being taken along with the suspect drug.
Manufacturer Name Product NDC Package NDC
Medicinal Product VITAMIN D3
  • Strides Pharma Science Limited
  • 64380-737
Generic Name ERGOCALCIFEROL
Brand Name
VITAMIN D
Active Substance Name CHOLECALCIFEROL
Drug Indication Product used for unknown indication
Drug Administration Route Unknown

Drug #8

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Concomitant”
The drug was reported as being taken along with the suspect drug.
Manufacturer Name Product NDC Package NDC
Medicinal Product ZINC
  • Boiron
  • Hospira, Inc.
  • Laboratoire Aguettant
  • Natural Health Supply
  • Sanum Kehlbeck GmbH & Co. KG
  • Seroyal USA
  • Wal-Mart Stores,Inc.,
  • Washington Homeopathic Products
  • 0220-5433
  • 0220-5434
  • 0220-5435
  • 0220-5436
  • 0220-5437
  • 0220-5438
  • 0220-5439
  • 0220-5440
  • 0220-5465
  • 49035-881
  • 60681-5501
  • 60710-001
  • 62106-5367
  • 64117-052
  • 68428-167
  • 68428-712
  • 0409-4090
Generic Name ZINC CHLORIDE, ZINC GLUCONATE, ZINC
Brand Name
ZINC INJECTABLE A 1MG/ML, SOLUTION INJECTABLE POUR PERFUSION, ZINCUM METALLICUM KIT REFILL, NEURALGIA HEADACHE, ZINCUM METALLICUM, ZINC, PLEO ZINC
Active Substance Name ZINC
Drug Indication Product used for unknown indication
Drug Administration Route Unknown

Drug #9

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Suspect”
The drug was considered by the reporter to be the cause.
Manufacturer Name Product NDC Package NDC
Medicinal Product AMPYRA
  • Acorda Therapeutics, Inc.
  • 10144-427
Generic Name DALFAMPRIDINE
Brand Name
AMPYRA
Active Substance Name DALFAMPRIDINE
Drug Indication Gait disturbance
Drug Administration Route Oral

Drug #10

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Concomitant”
The drug was reported as being taken along with the suspect drug.
Manufacturer Name Product NDC Package NDC
Medicinal Product BIOTIN
  • Bonogen Co., Ltd
  • Cresson
  • SPAI-SONS PHARMACEUTICAL INTERNATIONAL COSMETICS
  • 49658-2001
  • 49658-4001
  • 50653-3001
  • 66854-007
  • 66854-011
  • 66854-020
  • 66854-010
Generic Name BIOTIN
Brand Name
SPAI-SONS PROCAPELL, BIONA-VIT CONTROLS AND PREVENTS HAIR LOSS, HAIRQ-PLUS, BONOGEN ACTIVATOR HAIR LOSS TREATMENT, TK-NAX, SPAI-SONS PROLAC-VIT
Active Substance Name BIOTIN
Drug Indication Product used for unknown indication
Drug Administration Route Unknown

Drug #11

Date the patient began taking the drug and date the patient stopped taking the drug: -
Drug Characterization “Concomitant”
The drug was reported as being taken along with the suspect drug.
Manufacturer Name Product NDC Package NDC
Medicinal Product NAPROXEN
  • Allegiant Health
  • Amerisource Bergen
  • Amneal Pharmaceuticals LLC
  • Amneal Pharmaceuticals of New York LLC
  • Athena Bioscience
  • Aurobindo Pharma Limited
  • Biomes Pharmaceuticals
  • Cadila Healthcare Limited
  • Camber Pharmaceuticals
  • Cameron Pharmaceuticals, LLC
  • Canton Laboratories
  • Cipla USA Inc.
  • Citron Pharma LLC
  • Exelan Pharmaceuticals, Inc.
  • Glenmark Pharmaceuticals Limited Inc., USA
  • H.J. Harkins Company., Inc.
  • Key Therapeutics, LLC
  • MARKSANS PHARMA LIMITED
  • Medline Industries, Inc.
  • Palmetto Pharmaceuticals
  • Polygen Pharmaceuticals LLC
  • Teva Pharmaceuticals USA, Inc.
  • TIME CAP LABORATORIES
  • WALGREENS
  • West-Ward Pharmaceuticals Corp
  • Woodward Pharma Services LLC
  • Zee Medical Inc
  • Zydus Pharmaceuticals (USA) Inc.
  • 0093-1005
  • 0093-1006
  • 0143-1346
  • 0143-1347
  • 0143-1348
  • 0143-9908
  • 0143-9916
  • 0363-9609
  • 25000-138
  • 25000-139
  • 25000-140
  • 31722-338
  • 31722-339
  • 31722-340
  • 31722-341
  • 31722-342
  • 35418-000
  • 42494-400
  • 42494-402
  • 42494-403
  • 42494-404
  • 42494-405
  • 42494-407
  • 42494-408
  • 46122-562
  • 46122-564
  • 49483-617
  • 49483-618
  • 49483-619
  • 52605-138
  • 52605-139
  • 52605-140
  • 52959-193
  • 53329-675
  • 53746-188
  • 53746-189
  • 53746-190
  • 57237-214
  • 57237-215
  • 57237-216
  • 65162-188
  • 65162-189
  • 65162-190
  • 65841-676
  • 65841-677
  • 65841-678
  • 65862-520
  • 65862-521
  • 65862-522
  • 68134-201
  • 68382-012
  • 68382-013
  • 68382-014
  • 68462-178
  • 68462-179
  • 68462-188
  • 68462-190
  • 69097-851
  • 69097-852
  • 69097-853
  • 69097-854
  • 69097-855
  • 69150-138
  • 69150-139
  • 69150-140
  • 69168-361
  • 69437-028
  • 69437-203
  • 69437-316
  • 69437-415
  • 69437-416
  • 69784-500
  • 69784-501
  • 69784-505
  • 69784-550
  • 70868-200
  • 71511-701
  • 76282-340
  • 76282-341
  • 76282-342
  • 68462-189
Generic Name NAPROXEN SODIUM 220 MG, NAPROXEN SODIUM, NAPROXEN
Brand Name
NAPROXEN DELAYED RELEASE, EC-NAPROSYN, EC-NAPROXEN, NAPROSYN, NAPROXEN, NAPROXEN ALL DAY RELIEF FOR PAIN, BACK AND MUSCLE PAIN
Active Substance Name NAPROXEN
Drug Indication Product used for unknown indication
Drug Administration Route Unknown