Gravitate Health FHIR Implementation Guide
0.1.0 - CI Build

Gravitate Health FHIR Implementation Guide, published by Gravitate Health Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/gravitate-health/ and changes regularly. See the Directory of published versions

: ePI document Bundle for Humira 40 mg Solution for injection Subcutaneous use pre-filled syringe (glass) Package Leaflet for language en - XML Representation

Raw xml | Download


<Bundle xmlns="http://hl7.org/fhir">
  <id value="bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Bundle-uv-epi"/>
  </meta>
  <language value="en"/>
  <identifier>
    <system value="https://www.gravitatehealth.eu/sid/doc"/>
    <value value="sid"/>
  </identifier>
  <type value="document"/>
  <timestamp value="2023-06-27T10:09:22Z"/>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Composition/composition-en-f97db27e6330f77484eb8425ad2913cd"/>
    <resource>
      <Composition>
        <id value="composition-en-f97db27e6330f77484eb8425ad2913cd"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Composition-uv-epi"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><a name="Composition_composition-en-f97db27e6330f77484eb8425ad2913cd"> </a><p class="res-header-id"><b>Generated Narrative: Composition composition-en-f97db27e6330f77484eb8425ad2913cd</b></p><a name="composition-en-f97db27e6330f77484eb8425ad2913cd"> </a><a name="hccomposition-en-f97db27e6330f77484eb8425ad2913cd"> </a><a name="composition-en-f97db27e6330f77484eb8425ad2913cd-en-US"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Language: en</p><p style="margin-bottom: 0px">Profile: <a href="https://build.fhir.org/ig/HL7/emedicinal-product-info/StructureDefinition-Composition-uv-epi.html">Composition (ePI)</a></p></div><p><b>identifier</b>: <code>https://spor.ema.europa.eu/rmswi/</code>/a14be1b1a1c674243176b59de5d183f9</p><p><b>status</b>: Final</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi/ 100000155538}">Package Leaflet</span></p><p><b>category</b>: <span title="Codes:{http://hl7.eu/fhir/ig/gravitate-health/CodeSystem/epicategory-cs R}">Raw</span></p><p><b>date</b>: 2022-02-16 13:28:17+0000</p><p><b>author</b>: <a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#Organization_mah-63db764f02d280689a772e5827bb2515">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></p><p><b>title</b>: TEST PURPOSES ONLY - Humira 40 mg Solution for injection Subcutaneous use pre-filled syringe (glass)</p><h3>Attesters</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Mode</b></td><td><b>Time</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/composition-attestation-mode official}">Official</span></td><td>2022-02-16 13:28:17+0000</td></tr></table></div>
        </text>
        <identifier>
          <system value="https://spor.ema.europa.eu/rmswi/"/>
          <value value="a14be1b1a1c674243176b59de5d183f9"/>
        </identifier>
        <status value="final"/>
        <type>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi/"/>
            <code value="100000155538"/>
          </coding>
          <text value="Package Leaflet"/>
        </type>
        <category>
          <coding>
            <system
                    value="http://hl7.eu/fhir/ig/gravitate-health/CodeSystem/epicategory-cs"/>
            <code value="R"/>
            <display value="Raw"/>
          </coding>
        </category>
        <subject>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </subject>
        <date value="2022-02-16T13:28:17Z"/>
        <author>
          <reference
                     value="Organization/mah-63db764f02d280689a772e5827bb2515"/>
        </author>
        <title
               value="TEST PURPOSES ONLY - Humira 40 mg Solution for injection Subcutaneous use pre-filled syringe (glass)"/>
        <attester>
          <mode>
            <coding>
              <system
                      value="http://hl7.org/fhir/composition-attestation-mode"/>
              <code value="official"/>
            </coding>
          </mode>
          <time value="2022-02-16T13:28:17Z"/>
        </attester>
        <section>
          <title value="B. Package Leaflet"/>
          <code>
            <coding>
              <system value="https://spor.ema.europa.eu/rmswi/"/>
              <code value="100000155538"/>
            </coding>
            <text value="B. Package Leaflet"/>
          </code>
          <text>
            <status value="additional"/>
            <div xmlns="http://www.w3.org/1999/xhtml">unavailable</div>
          </text>
          <emptyReason>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/list-empty-reason"/>
              <code value="unavailable"/>
            </coding>
          </emptyReason>
          <section>
            <title value="Package leaflet: Information for the user"/>
            <code>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi/"/>
                <code value="100000155538"/>
              </coding>
              <text value="Package leaflet: Information for the user"/>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><p>Humira 40 mg solution for injection in pre-filled syringe adalimumab</p><p>Read all of this leaflet carefully before your child starts using this medicine because it contains important information.</p><ul><li>Keep this leaflet. You may need to read it again.</li><li>Your doctor will also give you a Patient Reminder Card, which contains important safety information that you need to be aware of before your child begins using Humira and during treatment with Humira. Keep this Patient Reminder Card with you or your child.</li><li>If you have any questions, ask your doctor or pharmacist.</li><li>This medicine has been prescribed for your child only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as your child.</li><li>If your child gets any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.</li></ul></div>
            </text>
          </section>
          <section>
            <title value="What is in this leaflet"/>
            <code>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi/"/>
                <code value="100000155538"/>
              </coding>
              <text value="What is in this leaflet"/>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><p>What is in this leaflet</p><ol><li>What Humira is and what it is used for</li><li>What you need to know before your child uses Humira</li><li>How to use Humira</li><li>Possible side effects</li><li>How to store Humira</li><li>Contents of the pack and other information</li><li>Injecting Humira</li></ol></div>
            </text>
          </section>
          <section>
            <title value="1. What 0 is and what it is used for"/>
            <code>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi/"/>
                <code value="100000155538"/>
              </coding>
              <text value="1. What 0 is and what it is used for"/>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><p>What Humira is and what it is used for Humira contains the active substance adalimumab. Humira is intended for the treatment of the inflammatory diseases described below:</p><ul><li>Polyarticular juvenile idiopathic arthritis</li><li>Enthesitis-related arthritis</li><li>Paediatric plaque psoriasis</li><li>Paediatric Crohn’s disease</li><li>Paediatric uveitis The active ingredient in Humira, adalimumab, is a human monoclonal antibody. Monoclonal antibodies are proteins that attach to a specific target.</li></ul><p>The target of adalimumab is a protein called tumour necrosis factor (TNFα), which is involved in the immune (defence) system and is present at increased levels in the inflammatory diseases listed above. By attaching to TNFα, Humira decreases the process of inflammation in these diseases.</p><p><strong>Polyarticular juvenile idiopathic arthritis</strong></p><p>Polyarticular juvenile idiopathic arthritis is an inflammatory disease of the joints that usually first appears in childhood.</p><p>Humira is used to treat polyarticular juvenile idiopathic arthritis in patients from 2 years of age. Your child may first be given other disease-modifying medicines, such as methotrexate. If these medicines do not work well enough, your child will be given Humira to treat his/her polyarticular juvenile idiopathic arthritis. Your doctor will decide if Humira should be used with methotrexate or alone.</p><p><strong>Enthesitis-related arthritis</strong></p><p>Enthesitis-related arthritis is an inflammatory disease of the joints and the places where tendons join the bone. Humira is used to treat enthesitis-related arthritis in patients from 6 years of age. Your child may first be given other disease-modifying medicines, such as methotrexate. If these medicines do not work well enough, your child will be given Humira to treat his/her enthesitis-related arthritis.</p><p><strong>Paediatric plaque psoriasis</strong></p><p>Plaque psoriasis is a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales. Plaque psoriasis can also affect the nails, causing them to crumble, become thickened and lift away from the nail bed which can be painful. Psoriasis is believed to be caused by a problem with the body’s immune system that leads to an increased production of skin cells. Humira is used to treat severe chronic plaque psoriasis in children and adolescents aged 4 to 17 years for whom topical therapy and phototherapies have either not worked very well or are not suitable.</p><p><strong>Paediatric Crohn’s disease</strong></p><p>Crohn’s disease is an inflammatory disease of the digestive tract. Humira is used to treat moderate to severe Crohn’s disease in children and adolescents aged 6 to 17 years. Your child may first be given other medicines. If these medicines do not work well enough, your child will be given Humira to reduce the signs and symptoms of his/her disease.</p><p><strong>Paediatric uveitis</strong></p><p>Non-infectious uveitis is an inflammatory disease affecting certain parts of the eye. Humira is used to treat children with chronic non-infectious uveitis from 2 years of age with inflammation affecting the front of the eye This inflammation may lead to a decrease of vision and/or the presence of floaters in the eye (black dots or wispy lines that move across the field of vision). Humira works by reducing this inflammation. Your child may first be given other medicines. If these medicines do not work well enough, your child will be given Humira to reduce the signs and symptoms of his/her disease.</p></div>
            </text>
          </section>
          <section>
            <title value="2. What you need to know before you take 0"/>
            <code>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi/"/>
                <code value="100000155538"/>
              </coding>
              <text value="2. What you need to know before you take 0"/>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><h2 id="warnings-and-precautions">Warnings and precautions</h2><p>Talk to your doctor or pharmacist before using Humira. <strong>Allergic reactions</strong></p><ul><li>If your child gets allergic reactions with symptoms such as chest tightness, wheezing, dizziness, swelling or rash do not inject more Humira and contact your doctor immediately since, in rare cases, these reactions can be life threatening.</li></ul><p><strong>Infections</strong></p><ul><li>If your child has an infection, including long-term infection or an infection in one part of the body (for example, leg ulcer) consult your doctor before starting Humira. If you are unsure, contact your doctor.</li><li>Your child might get infections more easily while he/she is receiving Humira treatment. This risk may increase if your child has problems with his/her lungs. These infections may be serious and include:<ul><li>tuberculosis</li><li>infections caused by viruses, fungi, parasites or bacteria</li><li>severe infection in the blood (sepsis) In rare cases, these infections can be life-threatening. It is important to tell your doctor if your child gets symptoms such as fever, wounds, feeling tired or dental problems. Your doctor may tell you to stop using Humira for some time.</li></ul></li><li>Tell your doctor if your child lives or travels in regions where fungal infections (for example, histoplasmosis, coccidioidomycosis or blastomycosis) are very common.</li><li>Tell your doctor if your child has had infections which keep coming back or other conditions that increase the risk of infections.</li><li>Your child and his/her doctor should pay special attention to signs of infection while your child is being treated with Humira. It is important to tell your doctor if your child gets symptoms of infections, such as fever, wounds, feeling tired or dental problems.</li></ul><p><strong>Tuberculosis</strong></p><ul><li>As cases of tuberculosis have been reported in patients treated with Humira, your doctor will check your child for signs and symptoms of tuberculosis before starting Humira. This will include a thorough medical evaluation including your child’s medical history and appropriate screening tests (for example, chest X-ray and a tuberculin test). The conduct and results of these tests should be recorded on your child’s Patient Reminder Card.<ul><li>It is very important that you tell your doctor if your child has ever had tuberculosis, or if your child has been in close contact with someone who has had tuberculosis. If your child has active tuberculosis, do not use Humira.</li><li>Tuberculosis can develop during therapy even if your child has received treatment for the prevention of tuberculosis.</li><li>If symptoms of tuberculosis (for example, cough that does not go away, weight loss, lack of energy, mild fever), or any other infection appear during or after therapy tell your doctor immediately.</li></ul></li></ul><p><strong>Hepatitis B</strong></p><ul><li>Tell your doctor if your child is a carrier of the hepatitis B virus (HBV), if he/she has active HBV or if you think he/she might be at risk of getting HBV.</li><li>Your doctor should test your child for HBV. In people who carry HBV, Humira can cause the virus to become active again.</li><li>In some rare cases, especially if your child is taking other medicines that suppress theimmune system, reactivation of HBV can be life-threatening.</li></ul><p><strong>Surgery or dental procedure</strong></p><ul><li>If your child is about to have surgery or dental procedures please inform your doctor that your child is taking Humira. Your doctor may recommend temporary discontinuation of Humira.</li></ul><p><strong>Demyelinating disease</strong></p><ul><li>If your child has or develops a demyelinating disease (a disease that affects the insulating layer around the nerves, such as multiple sclerosis), your doctor will decide if he/she should receive or continue to receive Humira. Tell your doctor immediately if your child experiences symptoms like changes in vision, weakness in arms or legs or numbness or tingling in any part of the body.</li></ul><p><strong>Vaccinations</strong></p><ul><li>Certain vaccines may cause infections and should not be given while receiving Humira.<ul><li>Check with your doctor before your child receives any vaccines.</li><li>It is recommended that children, if possible, be given all the scheduled vaccinations for their age before they start treatment with Humira.</li><li>If your child received Humira while she was pregnant, her baby may be at higher risk for getting such an infection for up to approximately five months after the last Humira dose she received during pregnancy. It is important that you tell her baby&#39;s doctors and other health care professionals about your child&#39;s Humira use during her pregnancy so they can decide when her baby should receive any vaccine.</li></ul></li></ul><p><strong>Heart failure</strong></p><ul><li>If your child has mild heart failure and is being treated with Humira, his/her heart failure status must be closely monitored by your doctor. It is important to tell your doctor if your child has had or has a serious heart condition. If he/she develops new or worsening symptoms of heart failure (e.g. shortness of breath, or swelling of your feet), you must contact your doctor immediately. Your doctor will decide if your child should receive Humira. <strong>Fever, bruising, bleeding or looking pale</strong></li><li>In some patients the body may fail to produce enough of the blood cells that fight off infections or help your child to stop bleeding. Your doctor may decide to stop treatment. If your child develops a fever that does not go away, develops light bruises or bleeds very easily or looks very pale, call your doctor right away.</li></ul><p><strong>Cancer</strong></p><ul><li>There have been very rare cases of certain kinds of cancer in children and adult patients taking Humira or other TNF blockers.<ul><li>People with more serious rheumatoid arthritis that have had the disease for a long time may have a higher than average risk of getting lymphoma (a cancer that affects the lymph system) and leukaemia (a cancer that affects the blood and bone marrow).</li><li>If your child takes Humira the risk of getting lymphoma, leukaemia, or other cancers may increase. On rare occasions, an uncommon and severe type of lymphoma, has been seen in patients taking Humira. Some of those patients were also treated with azathioprine or 6- mercaptopurine.</li><li>Tell your doctor if your child is taking azathioprine or 6-mercaptopurine with Humira.</li><li>Cases of non-melanoma skin cancer have been observed in patients taking Humira.</li><li>If new skin lesions appear during or after therapy or if existing lesions change appearance, tell your doctor.</li><li>There have been cases of cancers, other than lymphoma in patients with a specific type of lung disease called Chronic Obstructive Pulmonary Disease (COPD) treated with another TNF blocker. If your child has COPD, or is a heavy smoker, you should discuss with your doctor whether treatment with a TNF blocker is appropriate for your child. <strong>Autoimmune disease</strong></li></ul></li><li>On rare occasions, treatment with Humira could result in lupus-like syndrome. Contact your doctor if symptoms such as persistent unexplained rash, fever, joint pain or tiredness occur.</li></ul></div>
            </text>
          </section>
          <section>
            <title value="3. How to take 0"/>
            <code>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi/"/>
                <code value="100000155538"/>
              </coding>
              <text value="3. How to take 0"/>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><h2 id="how-to-use-humira">How to use Humira</h2><p>Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. The recommended doses for Humira in each of the approved uses are shown in the following table. Your doctor may prescribe another strength of Humira if your child needs a different dose.</p><p><strong>Method and route of administration</strong> Humira is administered by injection under the skin (by subcutaneous injection). <strong>Detailed instructions on how to inject Humira are provided in section 7 ‘Injecting Humira’.</strong></p><p><strong>If you use more Humira than you should</strong> If you accidentally inject Humira more frequently than told to by your doctor or pharmacist, call your doctor or pharmacist and tell them that your child has taken more. Always take the outer carton of the medicine with you, even if it is empty. <strong>If you forget to use Humira</strong> If you forget to give your child an injection, you should inject the next dose of Humira as soon as you remember. Then give your child’s next dose as you would have on the originally scheduled day, had you not forgotten a dose. <strong>If you stop using Humira</strong> The decision to stop using Humira should be discussed with your doctor. Your child’s symptoms may return if you stop using Humira. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.</p></div>
            </text>
          </section>
          <section>
            <title value="4. Possible side effects"/>
            <code>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi/"/>
                <code value="100000155538"/>
              </coding>
              <text value="4. Possible side effects"/>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><h2 id="possible-side-effects">Possible side effects</h2><p>Like all medicines, this medicine can cause side effects, although not everybody gets them. Most side effects are mild to moderate. However, some may be serious and require treatment. Side effects may occur at least up to 4 months after the last Humira injection.</p><p><strong>Tell your doctor immediately if you notice any of the following</strong></p><ul><li>severe rash, hives or other signs of allergic reaction</li><li>swollen face, hands, feet</li><li>trouble breathing, swallowing</li><li>shortness of breath with physical activity or upon lying down or swelling of the feet <strong>Tell your doctor as soon as possible if you notice any of the following</strong></li><li>signs of infection such as fever, feeling sick, wounds, dental problems, burning on urination</li><li>feeling weak or tired</li><li>coughing</li><li>tingling</li><li>numbness</li><li>double vision</li><li>arm or leg weakness</li><li>a bump or open sore that doesn&#39;t heal</li><li>signs and symptoms suggestive of blood disorders such as persistent fever, bruising, bleeding, paleness The symptoms described above can be signs of the below listed side effects, which have been observed with Humira.</li></ul><p><strong>Very common</strong> (may affect more than 1 in 10 people)</p><ul><li>injection site reactions (including pain, swelling, redness or itching)</li><li>respiratory tract infections (including cold, runny nose, sinus infection, pneumonia)</li><li>headache</li><li>abdominal pain</li><li>nausea and vomiting</li><li>rash</li><li>musculoskeletal pain</li></ul><p><strong>Common</strong> (may affect up to 1 in 10 people)</p><ul><li>serious infections (including blood poisoning and influenza)</li><li>intestinal infections (including gastroenteritis)</li><li>skin infections (including cellulitis and shingles)</li><li>ear infections</li><li>oral infections (including tooth infections and cold sores)</li><li>reproductive tract infections</li><li>urinary tract infection</li><li>fungal infections</li><li>joint infections</li><li>benign tumours</li><li>skin cancer</li><li>allergic reactions (including seasonal allergy)</li><li>dehydration</li><li>mood swings (including depression)</li><li>anxiety</li><li>difficulty sleeping</li><li>sensation disorders such as tingling, prickling or numbness</li><li>migraine</li><li>nerve root compression (including low back pain and leg pain)</li><li>vision disturbances</li><li>eye inflammation</li><li>inflammation of the eye lid and eye swelling</li><li>vertigo (feeling of dizziness or spinning)</li><li>sensation of heart beating rapidly</li><li>high blood pressure</li><li>flushing</li><li>haematoma (collection of blood outside of blood vessels)</li><li>cough</li><li>asthma</li><li>shortness of breath</li><li>gastrointestinal bleeding</li><li>dyspepsia (indigestion, bloating, heart burn)</li><li>acid reflux disease</li><li>sicca syndrome (including dry eyes and dry mouth)</li><li>itching</li><li>itchy rash</li><li>bruising</li><li>inflammation of the skin (such as eczema)</li><li>breaking of finger nails and toe nails</li><li>increased sweating</li><li>hair loss</li><li>new onset or worsening of psoriasis</li><li>muscle spasms</li><li>blood in urine</li><li>kidney problems</li><li>chest pain</li><li>oedema (swelling)</li><li>fever</li><li>reduction in blood platelets which increases risk of bleeding or bruising</li><li>impaired healing</li></ul><p><strong>Uncommon</strong> (may affect up to 1 in 100 people)</p><ul><li>opportunistic infections (which include tuberculosis and other infections that occur when resistance to disease is lowered)</li><li>neurological infections (including viral meningitis)</li><li>eye infections</li><li>bacterial infections</li><li>diverticulitis (inflammation and infection of the large intestine)</li><li>cancer</li><li>cancer that affects the lymph system</li><li>melanoma</li><li>immune disorders that could affect the lungs, skin and lymph nodes (most commonly presenting as sarcoidosis)</li><li>vasculitis (inflammation of blood vessels)</li><li>tremor (shaking)</li><li>neuropathy (disorder of the nerves)</li><li>stroke</li><li>hearing loss, buzzing</li><li>sensation of heart beating irregularly such as skipped beats</li><li>heart problems that can cause shortness of breath or ankle swelling</li><li>heart attack</li><li>a sac in the wall of a major artery, inflammation and clot of a vein, blockage of a blood vessel</li><li>lung diseases causing shortness of breath (including inflammation)</li><li>pulmonary embolism (blockage in an artery of the lung)</li><li>pleural effusion (abnormal collection of fluid in the pleural space)</li><li>inflammation of the pancreas which causes severe pain in the abdomen and back</li><li>difficulty in swallowing</li><li>facial oedema (swelling of the face)</li><li>gallbladder inflammation, gallbladder stones</li><li>fatty liver</li><li>night sweats</li><li>scar</li><li>abnormal muscle breakdown</li><li>systemic lupus erythematosus (including inflammation of skin, heart, lung, joints and other organ systems)</li><li>sleep interruptions</li><li>impotence</li><li>inflammations</li></ul><p><strong>Rare</strong> (may affect up to 1 in 1,000 people)</p><ul><li>leukaemia (cancer affecting the blood and bone marrow)</li><li>severe allergic reaction with shock</li><li>multiple sclerosis</li><li>nerve disorders (such as eye nerve inflammation and Guillain-Barré syndrome that may cause muscle weakness, abnormal sensations, tingling in the arms and upper body)</li><li>heart stops pumping</li><li>pulmonary fibrosis (scarring of the lung)</li><li>intestinal perforation (hole in the intestine)</li><li>hepatitis</li><li>reactivation of hepatitis B</li><li>autoimmune hepatitis (inflammation of the liver caused by the body&#39;s own immune system)</li><li>cutaneous vasculitis (inflammation of blood vessels in the skin)</li><li>Stevens-Johnson syndrome (early symptoms include malaise, fever, headache and rash)</li><li>facial oedema (swelling of the face) associated with allergic reactions</li><li>erythema multiforme (inflammatory skin rash)</li><li>lupus-like syndrome</li><li>angioedema (localized swelling of the skin)</li><li>lichenoid skin reaction (itchy reddish-purple skin rash)</li></ul><p><strong>Not known</strong> (frequency cannot be estimated from the available data)</p><ul><li>hepatosplenic T-cell lymphoma (a rare blood cancer that is often fatal)</li><li>Merkel cell carcinoma (a type of skin cancer)</li><li>Kaposi’s sarcoma, a rare cancer related to infection with human herpes virus 8. Kaposi’s sarcoma most commonly appears as purple lesions on the skin</li><li>liver failure</li><li>worsening of a condition called dermatomyositis (seen as a skin rash accompanying muscle weakness)</li><li>weight gain (for most patients, the weight gain was small) Some side effects observed with Humira may not have symptoms and may only be discovered through blood tests. These include: <strong>Very common</strong> (may affect more than 1 in 10 people)</li><li>low blood measurements for white blood cells</li><li>low blood measurements for red blood cells</li><li>increased lipids in the blood</li><li>elevated liver enzymes</li></ul><p><strong>Common</strong> (may affect up to 1 in 10 people)</p><ul><li>high blood measurements for white blood cells</li><li>low blood measurements for platelets</li><li>increased uric acid in the blood</li><li>abnormal blood measurements for sodium</li><li>low blood measurements for calcium</li><li>low blood measurements for phosphate</li><li>high blood sugar</li><li>high blood measurements for lactate dehydrogenase</li><li>autoantibodies present in the blood</li><li>low blood potassium <strong>Uncommon</strong> (may affect up to 1 in 100 people)</li><li>elevated bilirubin measurement (liver blood test) <strong>Rare</strong> (may affect up to 1 in 1,000 people)</li><li>low blood measurements for white blood cells, red blood cells and platelet count</li></ul><p><strong>Reporting of side effects</strong> If your child gets any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects, you can help provide more information on the safety of this medicine.</p></div>
            </text>
          </section>
          <section>
            <title value="5. How to store 0"/>
            <code>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi/"/>
                <code value="100000155538"/>
              </coding>
              <text value="5. How to store 0"/>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><h2 id="how-to-store-humira">How to store Humira</h2><p>Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date stated on the label/blister/carton after EXP. Store in a refrigerator (2ºC – 8ºC). Do not freeze. Keep the pre-filled syringe in the outer carton in order to protect from light. Alternative Storage: When needed (for example, when you are travelling), a single Humira pre-filled syringe may be stored at room temperature (up to 25°C) for a maximum period of 14 days – be sure to protect it from light. Once removed from the refrigerator for room temperature storage, the syringe <strong>must be used within 14 days or discarded</strong>, even if it is returned to the refrigerator. You should record the date when the syringe is first removed from refrigerator and the date after which it should be discarded. Do not throw away any medicines via wastewater or household waste. Ask your doctor or pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.</p></div>
            </text>
          </section>
          <section>
            <title value="6. Contents of the pack and other information"/>
            <code>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi/"/>
                <code value="100000155538"/>
              </coding>
              <text value="6. Contents of the pack and other information"/>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml">unavailable</div>
            </text>
            <emptyReason>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/list-empty-reason"/>
                <code value="unavailable"/>
              </coding>
            </emptyReason>
          </section>
        </section>
      </Composition>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Ingredient/ingredient-for-humira-mannitol"/>
    <resource>
      <Ingredient>
        <id value="ingredient-for-humira-mannitol"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Ingredient-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Ingredient_ingredient-for-humira-mannitol"> </a><p class="res-header-id"><b>Generated Narrative: Ingredient ingredient-for-humira-mannitol</b></p><a name="ingredient-for-humira-mannitol"> </a><a name="hcingredient-for-humira-mannitol"> </a><a name="ingredient-for-humira-mannitol-en-US"> </a><p><b>identifier</b>: <code>https://gsrs.ncats.nih.gov/ginas/app/beta</code>/3OWL53L36A (use: official, )</p><p><b>status</b>: Active</p><p><b>for</b>: </p><ul><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#AdministrableProductDefinition_ap-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li></ul><p><b>role</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072082}">Excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Concept</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://gsrs.ncats.nih.gov/ginas/app/beta 3OWL53L36A}">Mannitol</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
          <value value="3OWL53L36A"/>
        </identifier>
        <status value="active"/>
        <for>
          <reference
                     value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <for>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </for>
        <for>
          <reference
                     value="AdministrableProductDefinition/ap-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <role>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072082"/>
            <display value="Excipient"/>
          </coding>
        </role>
        <substance>
          <code>
            <concept>
              <coding>
                <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
                <code value="3OWL53L36A"/>
                <display value="Mannitol"/>
              </coding>
            </concept>
          </code>
        </substance>
      </Ingredient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Ingredient/ingredient-for-humira-polysorbate80"/>
    <resource>
      <Ingredient>
        <id value="ingredient-for-humira-polysorbate80"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Ingredient-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Ingredient_ingredient-for-humira-polysorbate80"> </a><p class="res-header-id"><b>Generated Narrative: Ingredient ingredient-for-humira-polysorbate80</b></p><a name="ingredient-for-humira-polysorbate80"> </a><a name="hcingredient-for-humira-polysorbate80"> </a><a name="ingredient-for-humira-polysorbate80-en-US"> </a><p><b>identifier</b>: <code>https://gsrs.ncats.nih.gov/ginas/app/beta</code>/6OZP39ZG8H (use: official, )</p><p><b>status</b>: Active</p><p><b>for</b>: </p><ul><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#AdministrableProductDefinition_ap-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li></ul><p><b>role</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072082}">Excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Concept</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://gsrs.ncats.nih.gov/ginas/app/beta 6OZP39ZG8H}">Polysorbate 80</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
          <value value="6OZP39ZG8H"/>
        </identifier>
        <status value="active"/>
        <for>
          <reference
                     value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <for>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </for>
        <for>
          <reference
                     value="AdministrableProductDefinition/ap-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <role>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072082"/>
            <display value="Excipient"/>
          </coding>
        </role>
        <substance>
          <code>
            <concept>
              <coding>
                <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
                <code value="6OZP39ZG8H"/>
                <display value="Polysorbate 80"/>
              </coding>
            </concept>
          </code>
        </substance>
      </Ingredient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Ingredient/ingredient-for-humira-adalimumab"/>
    <resource>
      <Ingredient>
        <id value="ingredient-for-humira-adalimumab"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Ingredient-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Ingredient_ingredient-for-humira-adalimumab"> </a><p class="res-header-id"><b>Generated Narrative: Ingredient ingredient-for-humira-adalimumab</b></p><a name="ingredient-for-humira-adalimumab"> </a><a name="hcingredient-for-humira-adalimumab"> </a><a name="ingredient-for-humira-adalimumab-en-US"> </a><p><b>identifier</b>: <code>https://gsrs.ncats.nih.gov/ginas/app/beta</code>/FYS6T7F842 (use: official, )</p><p><b>status</b>: Active</p><p><b>for</b>: </p><ul><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#AdministrableProductDefinition_ap-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li></ul><p><b>role</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072072}">Active</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Concept</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://gsrs.ncats.nih.gov/ginas/app/beta FYS6T7F842}">adalimumab</span></td></tr></table><h3>Strengths</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Presentation[x]</b></td><td><b>Basis</b></td></tr><tr><td style="display: none">*</td><td>40 mg<span style="background: LightGoldenRodYellow"> (Details: UCUM  codemg = 'mg')</span></td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleClass ACTIB}">active ingredient - basis of strength</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
          <value value="FYS6T7F842"/>
        </identifier>
        <status value="active"/>
        <for>
          <reference
                     value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <for>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </for>
        <for>
          <reference
                     value="AdministrableProductDefinition/ap-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <role>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072072"/>
            <display value="Active"/>
          </coding>
        </role>
        <substance>
          <code>
            <concept>
              <coding>
                <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
                <code value="FYS6T7F842"/>
                <display value="adalimumab"/>
              </coding>
            </concept>
          </code>
          <strength>
            <presentationQuantity>
              <value value="40"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="mg"/>
            </presentationQuantity>
            <basis>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-RoleClass"/>
                <code value="ACTIB"/>
                <display value="active ingredient - basis of strength"/>
              </coding>
            </basis>
          </strength>
        </substance>
      </Ingredient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Ingredient/ingredient-for-humira-sterilewaterforinjection"/>
    <resource>
      <Ingredient>
        <id value="ingredient-for-humira-sterilewaterforinjection"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Ingredient-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Ingredient_ingredient-for-humira-sterilewaterforinjection"> </a><p class="res-header-id"><b>Generated Narrative: Ingredient ingredient-for-humira-sterilewaterforinjection</b></p><a name="ingredient-for-humira-sterilewaterforinjection"> </a><a name="hcingredient-for-humira-sterilewaterforinjection"> </a><a name="ingredient-for-humira-sterilewaterforinjection-en-US"> </a><p><b>identifier</b>: <code>https://gsrs.ncats.nih.gov/ginas/app/beta</code>/059QF0KO0R (use: official, )</p><p><b>status</b>: Active</p><p><b>for</b>: </p><ul><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#AdministrableProductDefinition_ap-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li></ul><p><b>role</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072082}">Excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Concept</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://gsrs.ncats.nih.gov/ginas/app/beta 059QF0KO0R}">STERILE WATER FOR INJECTION</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
          <value value="059QF0KO0R"/>
        </identifier>
        <status value="active"/>
        <for>
          <reference
                     value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <for>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </for>
        <for>
          <reference
                     value="AdministrableProductDefinition/ap-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <role>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072082"/>
            <display value="Excipient"/>
          </coding>
        </role>
        <substance>
          <code>
            <concept>
              <coding>
                <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
                <code value="059QF0KO0R"/>
                <display value="STERILE WATER FOR INJECTION"/>
              </coding>
            </concept>
          </code>
        </substance>
      </Ingredient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Ingredient/ingredient-for-humira-citricacidmonohydrate"/>
    <resource>
      <Ingredient>
        <id value="ingredient-for-humira-citricacidmonohydrate"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Ingredient-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Ingredient_ingredient-for-humira-citricacidmonohydrate"> </a><p class="res-header-id"><b>Generated Narrative: Ingredient ingredient-for-humira-citricacidmonohydrate</b></p><a name="ingredient-for-humira-citricacidmonohydrate"> </a><a name="hcingredient-for-humira-citricacidmonohydrate"> </a><a name="ingredient-for-humira-citricacidmonohydrate-en-US"> </a><p><b>identifier</b>: <code>https://gsrs.ncats.nih.gov/ginas/app/beta</code>/2968PHW8QP (use: official, )</p><p><b>status</b>: Active</p><p><b>for</b>: </p><ul><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#AdministrableProductDefinition_ap-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li></ul><p><b>role</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072082}">Excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Concept</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://gsrs.ncats.nih.gov/ginas/app/beta 2968PHW8QP}">CITRIC ACID MONOHYDRATE</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
          <value value="2968PHW8QP"/>
        </identifier>
        <status value="active"/>
        <for>
          <reference
                     value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <for>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </for>
        <for>
          <reference
                     value="AdministrableProductDefinition/ap-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <role>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072082"/>
            <display value="Excipient"/>
          </coding>
        </role>
        <substance>
          <code>
            <concept>
              <coding>
                <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
                <code value="2968PHW8QP"/>
                <display value="CITRIC ACID MONOHYDRATE"/>
              </coding>
            </concept>
          </code>
        </substance>
      </Ingredient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Ingredient/ingredient-for-humira-sodiumcitrateunspecifiedform"/>
    <resource>
      <Ingredient>
        <id value="ingredient-for-humira-sodiumcitrateunspecifiedform"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Ingredient-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Ingredient_ingredient-for-humira-sodiumcitrateunspecifiedform"> </a><p class="res-header-id"><b>Generated Narrative: Ingredient ingredient-for-humira-sodiumcitrateunspecifiedform</b></p><a name="ingredient-for-humira-sodiumcitrateunspecifiedform"> </a><a name="hcingredient-for-humira-sodiumcitrateunspecifiedform"> </a><a name="ingredient-for-humira-sodiumcitrateunspecifiedform-en-US"> </a><p><b>identifier</b>: <code>https://gsrs.ncats.nih.gov/ginas/app/beta</code>/1Q73Q2JULR (use: official, )</p><p><b>status</b>: Active</p><p><b>for</b>: </p><ul><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#AdministrableProductDefinition_ap-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li></ul><p><b>role</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072082}">Excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Concept</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://gsrs.ncats.nih.gov/ginas/app/beta 1Q73Q2JULR}">SODIUM CITRATE, UNSPECIFIED FORM</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
          <value value="1Q73Q2JULR"/>
        </identifier>
        <status value="active"/>
        <for>
          <reference
                     value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <for>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </for>
        <for>
          <reference
                     value="AdministrableProductDefinition/ap-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <role>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072082"/>
            <display value="Excipient"/>
          </coding>
        </role>
        <substance>
          <code>
            <concept>
              <coding>
                <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
                <code value="1Q73Q2JULR"/>
                <display value="SODIUM CITRATE, UNSPECIFIED FORM"/>
              </coding>
            </concept>
          </code>
        </substance>
      </Ingredient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Ingredient/ingredient-for-humira-sodiumphosphatemonobasicdihydrate"/>
    <resource>
      <Ingredient>
        <id value="ingredient-for-humira-sodiumphosphatemonobasicdihydrate"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Ingredient-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Ingredient_ingredient-for-humira-sodiumphosphatemonobasicdihydrate"> </a><p class="res-header-id"><b>Generated Narrative: Ingredient ingredient-for-humira-sodiumphosphatemonobasicdihydrate</b></p><a name="ingredient-for-humira-sodiumphosphatemonobasicdihydrate"> </a><a name="hcingredient-for-humira-sodiumphosphatemonobasicdihydrate"> </a><a name="ingredient-for-humira-sodiumphosphatemonobasicdihydrate-en-US"> </a><p><b>identifier</b>: <code>https://gsrs.ncats.nih.gov/ginas/app/beta</code>/5QWK665956 (use: official, )</p><p><b>status</b>: Active</p><p><b>for</b>: </p><ul><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#AdministrableProductDefinition_ap-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li></ul><p><b>role</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072082}">Excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Concept</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://gsrs.ncats.nih.gov/ginas/app/beta 5QWK665956}">SODIUM PHOSPHATE, MONOBASIC, DIHYDRATE</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
          <value value="5QWK665956"/>
        </identifier>
        <status value="active"/>
        <for>
          <reference
                     value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <for>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </for>
        <for>
          <reference
                     value="AdministrableProductDefinition/ap-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <role>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072082"/>
            <display value="Excipient"/>
          </coding>
        </role>
        <substance>
          <code>
            <concept>
              <coding>
                <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
                <code value="5QWK665956"/>
                <display value="SODIUM PHOSPHATE, MONOBASIC, DIHYDRATE"/>
              </coding>
            </concept>
          </code>
        </substance>
      </Ingredient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Ingredient/ingredient-for-humira-sodiumphosphatedibasicdihydrate"/>
    <resource>
      <Ingredient>
        <id value="ingredient-for-humira-sodiumphosphatedibasicdihydrate"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Ingredient-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Ingredient_ingredient-for-humira-sodiumphosphatedibasicdihydrate"> </a><p class="res-header-id"><b>Generated Narrative: Ingredient ingredient-for-humira-sodiumphosphatedibasicdihydrate</b></p><a name="ingredient-for-humira-sodiumphosphatedibasicdihydrate"> </a><a name="hcingredient-for-humira-sodiumphosphatedibasicdihydrate"> </a><a name="ingredient-for-humira-sodiumphosphatedibasicdihydrate-en-US"> </a><p><b>identifier</b>: <code>https://gsrs.ncats.nih.gov/ginas/app/beta</code>/94255I6E2T (use: official, )</p><p><b>status</b>: Active</p><p><b>for</b>: </p><ul><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#AdministrableProductDefinition_ap-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li></ul><p><b>role</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072082}">Excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Concept</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://gsrs.ncats.nih.gov/ginas/app/beta 94255I6E2T}">SODIUM PHOSPHATE, DIBASIC, DIHYDRATE</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
          <value value="94255I6E2T"/>
        </identifier>
        <status value="active"/>
        <for>
          <reference
                     value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <for>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </for>
        <for>
          <reference
                     value="AdministrableProductDefinition/ap-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <role>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072082"/>
            <display value="Excipient"/>
          </coding>
        </role>
        <substance>
          <code>
            <concept>
              <coding>
                <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
                <code value="94255I6E2T"/>
                <display value="SODIUM PHOSPHATE, DIBASIC, DIHYDRATE"/>
              </coding>
            </concept>
          </code>
        </substance>
      </Ingredient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Ingredient/ingredient-for-humira-sodiumchloride"/>
    <resource>
      <Ingredient>
        <id value="ingredient-for-humira-sodiumchloride"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Ingredient-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Ingredient_ingredient-for-humira-sodiumchloride"> </a><p class="res-header-id"><b>Generated Narrative: Ingredient ingredient-for-humira-sodiumchloride</b></p><a name="ingredient-for-humira-sodiumchloride"> </a><a name="hcingredient-for-humira-sodiumchloride"> </a><a name="ingredient-for-humira-sodiumchloride-en-US"> </a><p><b>identifier</b>: <code>https://gsrs.ncats.nih.gov/ginas/app/beta</code>/451W47IQ8X (use: official, )</p><p><b>status</b>: Active</p><p><b>for</b>: </p><ul><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li><li><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#AdministrableProductDefinition_ap-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></li></ul><p><b>role</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072082}">Excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Concept</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://gsrs.ncats.nih.gov/ginas/app/beta 451W47IQ8X}">Sodium chloride</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
          <value value="451W47IQ8X"/>
        </identifier>
        <status value="active"/>
        <for>
          <reference
                     value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <for>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </for>
        <for>
          <reference
                     value="AdministrableProductDefinition/ap-9b5b17469311c2ea4d1d08419748b4fb"/>
        </for>
        <role>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072082"/>
            <display value="Excipient"/>
          </coding>
        </role>
        <substance>
          <code>
            <concept>
              <coding>
                <system value="https://gsrs.ncats.nih.gov/ginas/app/beta"/>
                <code value="451W47IQ8X"/>
                <display value="Sodium chloride"/>
              </coding>
            </concept>
          </code>
        </substance>
      </Ingredient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/SubstanceDefinition/substance-adalimumab"/>
    <resource>
      <SubstanceDefinition>
        <id value="substance-adalimumab"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/SubstanceDefinition-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="SubstanceDefinition_substance-adalimumab"> </a><p class="res-header-id"><b>Generated Narrative: SubstanceDefinition substance-adalimumab</b></p><a name="substance-adalimumab"> </a><a name="hcsubstance-adalimumab"> </a><a name="substance-adalimumab-en-US"> </a><p><b>identifier</b>: <code>https://gsrs.ncats.nih.gov/ginas/app/beta/</code>/FYS6T7F842 (use: official, )</p><p><b>version</b>: 1</p><p><b>status</b>: <span title="Codes:{http://hl7.org/fhir/publication-status active}">Active</span></p><p><b>manufacturer</b>: <a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#Organization_mah-63db764f02d280689a772e5827bb2515">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></p><h3>Structures</h3><table class="grid"><tr><td style="display: none">-</td><td><b>MolecularFormula</b></td></tr><tr><td style="display: none">*</td><td>C6448H10026O2016N1732S42</td></tr></table></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://gsrs.ncats.nih.gov/ginas/app/beta/"/>
          <value value="FYS6T7F842"/>
        </identifier>
        <version value="1"/>
        <status>
          <coding>
            <system value="http://hl7.org/fhir/publication-status"/>
            <code value="active"/>
          </coding>
        </status>
        <manufacturer>
          <reference
                     value="Organization/mah-63db764f02d280689a772e5827bb2515"/>
        </manufacturer>
        <structure>
          <molecularFormula value="C6448H10026O2016N1732S42"/>
        </structure>
      </SubstanceDefinition>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/AdministrableProductDefinition/ap-9b5b17469311c2ea4d1d08419748b4fb"/>
    <resource>
      <AdministrableProductDefinition>
        <id value="ap-9b5b17469311c2ea4d1d08419748b4fb"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/AdministrableProductDefinition-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="AdministrableProductDefinition_ap-9b5b17469311c2ea4d1d08419748b4fb"> </a><p class="res-header-id"><b>Generated Narrative: AdministrableProductDefinition ap-9b5b17469311c2ea4d1d08419748b4fb</b></p><a name="ap-9b5b17469311c2ea4d1d08419748b4fb"> </a><a name="hcap-9b5b17469311c2ea4d1d08419748b4fb"> </a><a name="ap-9b5b17469311c2ea4d1d08419748b4fb-en-US"> </a><p><b>identifier</b>: <code>https://spor.ema.europa.eu/pmswi</code>/nan</p><p><b>status</b>: Active</p><p><b>formOf</b>: <a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></p><p><b>administrableDoseForm</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000073863}">Solution for injection</span></p><p><b>unitOfPresentation</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 200000002150}">Syringe</span></p><p><b>producedFrom</b>: <a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></p><blockquote><p><b>routeOfAdministration</b></p><p><b>code</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000073633}">Subcutaneous use</span></p><h3>TargetSpecies</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://spor.ema.europa.eu/rmswi 100000109093}">Human</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <system value="https://spor.ema.europa.eu/pmswi"/>
          <value value="nan"/>
        </identifier>
        <status value="active"/>
        <formOf>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </formOf>
        <administrableDoseForm>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000073863"/>
            <display value="Solution for injection"/>
          </coding>
        </administrableDoseForm>
        <unitOfPresentation>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="200000002150"/>
            <display value="Syringe"/>
          </coding>
        </unitOfPresentation>
        <producedFrom>
          <reference
                     value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        </producedFrom>
        <routeOfAdministration>
          <code>
            <coding>
              <system value="https://spor.ema.europa.eu/rmswi"/>
              <code value="100000073633"/>
              <display value="Subcutaneous use"/>
            </coding>
          </code>
          <targetSpecies>
            <code>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi"/>
                <code value="100000109093"/>
                <display value="Human"/>
              </coding>
            </code>
          </targetSpecies>
        </routeOfAdministration>
      </AdministrableProductDefinition>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/RegulatedAuthorization/authorization9b5b17469311c2ea4d1d08419748b4fb0"/>
    <resource>
      <RegulatedAuthorization>
        <id value="authorization9b5b17469311c2ea4d1d08419748b4fb0"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/RegulatedAuthorization-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="RegulatedAuthorization_authorization9b5b17469311c2ea4d1d08419748b4fb0"> </a><p class="res-header-id"><b>Generated Narrative: RegulatedAuthorization authorization9b5b17469311c2ea4d1d08419748b4fb0</b></p><a name="authorization9b5b17469311c2ea4d1d08419748b4fb0"> </a><a name="hcauthorization9b5b17469311c2ea4d1d08419748b4fb0"> </a><a name="authorization9b5b17469311c2ea4d1d08419748b4fb0-en-US"> </a><p><b>identifier</b>: <code>https://spor.ema.europa.eu/pmswi</code>/EU/1/03/256/022 (use: official, )</p><p><b>subject</b>: <a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 220000000061}">Marketing Authorisation</span></p><p><b>status</b>: <span title="Codes:{http://hl7.org/fhir/publication-status active}">Active</span></p><p><b>statusDate</b>: 2008-09-08</p><p><b>holder</b>: <a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#Organization_mah-63db764f02d280689a772e5827bb2515">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></p></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://spor.ema.europa.eu/pmswi"/>
          <value value="EU/1/03/256/022"/>
        </identifier>
        <subject>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </subject>
        <type>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="220000000061"/>
            <display value="Marketing Authorisation"/>
          </coding>
        </type>
        <status>
          <coding>
            <system value="http://hl7.org/fhir/publication-status"/>
            <code value="active"/>
            <display value="Active"/>
          </coding>
        </status>
        <statusDate value="2008-09-08"/>
        <holder>
          <reference
                     value="Organization/mah-63db764f02d280689a772e5827bb2515"/>
        </holder>
      </RegulatedAuthorization>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/Organization/mah-63db764f02d280689a772e5827bb2515"/>
    <resource>
      <Organization>
        <id value="mah-63db764f02d280689a772e5827bb2515"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/Organization-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_mah-63db764f02d280689a772e5827bb2515"> </a><p class="res-header-id"><b>Generated Narrative: Organization mah-63db764f02d280689a772e5827bb2515</b></p><a name="mah-63db764f02d280689a772e5827bb2515"> </a><a name="hcmah-63db764f02d280689a772e5827bb2515"> </a><a name="mah-63db764f02d280689a772e5827bb2515-en-US"> </a><p><b>identifier</b>: <code>https://spor.ema.europa.eu/omswi</code>/ORG-100000789 (use: official, )</p><p><b>active</b>: true</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 220000000034}">Marketing authorisation holder</span></p><p><b>name</b>: ACME industry</p><h3>Contacts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Address</b></td></tr><tr><td style="display: none">*</td><td>Knollstrasse Ludwigshafen Am Rhein Germany(work)</td></tr></table></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://spor.ema.europa.eu/omswi"/>
          <value value="ORG-100000789"/>
        </identifier>
        <active value="true"/>
        <type>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="220000000034"/>
            <display value="Marketing authorisation holder"/>
          </coding>
        </type>
        <name value="ACME industry"/>
        <contact>
          <address>
            <use value="work"/>
            <type value="physical"/>
            <text value="Knollstrasse Ludwigshafen Am Rhein Germany"/>
            <line value="Knollstrasse"/>
            <city value="Ludwigshafen Am Rhein"/>
            <postalCode value="67061"/>
            <country value="Germany"/>
          </address>
        </contact>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/PackagedProductDefinition/ppd-8cd75434ddd15aca2f0bc2efe5d26afe"/>
    <resource>
      <PackagedProductDefinition>
        <id value="ppd-8cd75434ddd15aca2f0bc2efe5d26afe"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/PackagedProductDefinition-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="PackagedProductDefinition_ppd-8cd75434ddd15aca2f0bc2efe5d26afe"> </a><p class="res-header-id"><b>Generated Narrative: PackagedProductDefinition ppd-8cd75434ddd15aca2f0bc2efe5d26afe</b></p><a name="ppd-8cd75434ddd15aca2f0bc2efe5d26afe"> </a><a name="hcppd-8cd75434ddd15aca2f0bc2efe5d26afe"> </a><a name="ppd-8cd75434ddd15aca2f0bc2efe5d26afe-en-US"> </a><p><b>name</b>: Humira 40 mg Solution for injection Subcutaneous use pre-filled syringe (glass) 2</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000155527}">Chemical Medicinal Product</span></p><p><b>packageFor</b>: <a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></p><p><b>status</b>: <span title="Codes:{http://hl7.org/fhir/publication-status active}">Active</span></p><p><b>statusDate</b>: 2008-09-08</p><blockquote><p><b>packaging</b></p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000073498}">Box</span></p><p><b>quantity</b>: 1</p><p><b>material</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 200000003529}">Cardboard</span></p><blockquote><p><b>packaging</b></p><p><b>identifier</b>: <code>https://spor.ema.europa.eu/pmswi</code>/123456</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000073544}">Pre-filled syringe</span></p><p><b>quantity</b>: 2</p><p><b>material</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 200000003204}">Glass type I</span></p><blockquote><p><b>containedItem</b></p><h3>Items</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Reference</b></td></tr><tr><td style="display: none">*</td><td><a href="Bundle-bundlepackageleaflet-en-9b5b17469311c2ea4d1d08419748b4fb.html#ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb">Bundle: identifier = https://www.gravitatehealth.eu/sid/doc#sid; type = document; timestamp = 2023-06-27 10:09:22+0000</a></td></tr></table></blockquote></blockquote></blockquote></div>
        </text>
        <name
              value="Humira 40 mg Solution for injection Subcutaneous use pre-filled syringe (glass) 2"/>
        <type>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000155527"/>
            <display value="Chemical Medicinal Product"/>
          </coding>
        </type>
        <packageFor>
          <reference
                     value="MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
        </packageFor>
        <status>
          <coding>
            <system value="http://hl7.org/fhir/publication-status"/>
            <code value="active"/>
            <display value="Active"/>
          </coding>
        </status>
        <statusDate value="2008-09-08"/>
        <packaging>
          <type>
            <coding>
              <system value="https://spor.ema.europa.eu/rmswi"/>
              <code value="100000073498"/>
              <display value="Box"/>
            </coding>
          </type>
          <quantity value="1"/>
          <material>
            <coding>
              <system value="https://spor.ema.europa.eu/rmswi"/>
              <code value="200000003529"/>
              <display value="Cardboard"/>
            </coding>
          </material>
          <packaging>
            <identifier>
              <system value="https://spor.ema.europa.eu/pmswi"/>
              <value value="123456"/>
            </identifier>
            <type>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi"/>
                <code value="100000073544"/>
                <display value="Pre-filled syringe"/>
              </coding>
            </type>
            <quantity value="2"/>
            <material>
              <coding>
                <system value="https://spor.ema.europa.eu/rmswi"/>
                <code value="200000003204"/>
                <display value="Glass type I"/>
              </coding>
            </material>
            <containedItem>
              <item>
                <reference>
                  <reference
                             value="ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
                </reference>
              </item>
            </containedItem>
          </packaging>
        </packaging>
      </PackagedProductDefinition>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/MedicinalProductDefinition/mpf97db27e6330f77484eb8425ad2913cd"/>
    <resource>
      <MedicinalProductDefinition>
        <id value="mpf97db27e6330f77484eb8425ad2913cd"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/MedicinalProductDefinition-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="MedicinalProductDefinition_mpf97db27e6330f77484eb8425ad2913cd"> </a><p class="res-header-id"><b>Generated Narrative: MedicinalProductDefinition mpf97db27e6330f77484eb8425ad2913cd</b></p><a name="mpf97db27e6330f77484eb8425ad2913cd"> </a><a name="hcmpf97db27e6330f77484eb8425ad2913cd"> </a><a name="mpf97db27e6330f77484eb8425ad2913cd-en-US"> </a><p><b>identifier</b>: <code>https://spor.ema.europa.eu/pmswi</code>/EU/1/03/256/022, <code>https://www.who-umc.org/phpid</code>/0xe72f98caa2b13cb3ccb489a1a7945c91</p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/medicinal-product-type MedicinalProduct}">Medicinal Product</span></p><p><b>domain</b>: <span title="Codes:{http://hl7.org/fhir/medicinal-product-domain Human}">Human use</span></p><p><b>status</b>: <span title="Codes:{http://hl7.org/fhir/publication-status active}">active</span></p><p><b>legalStatusOfSupply</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 100000072084}">Medicinal product subject to medical prescription</span></p><blockquote><p><b>name</b></p><p><b>productName</b>: Humira 40 mg Solution for injection Subcutaneous use pre-filled syringe (glass)</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/lists/220000000000 220000000001}">Full name</span></p><blockquote><p><b>part</b></p><p><b>part</b>: Humira</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/lists/220000000000 220000000002}">Invented name part</span></p></blockquote><blockquote><p><b>part</b></p><p><b>part</b>: Adalimumab</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/lists/220000000000 220000000003}">Scientific name part</span></p></blockquote><blockquote><p><b>part</b></p><p><b>part</b>: 40 mg</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/lists/220000000000 220000000004}">Strength part</span></p></blockquote><blockquote><p><b>part</b></p><p><b>part</b>: Solution for injection</p><p><b>type</b>: <span title="Codes:{https://spor.ema.europa.eu/lists/220000000000 220000000005}">Pharmaceutical dose form part</span></p></blockquote><h3>Usages</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Country</b></td><td><b>Jurisdiction</b></td><td><b>Language</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{urn:iso:std:iso:3166 ES}">Spain</span></td><td><span title="Codes:{urn:iso:std:iso:3166 ES}">Spain</span></td><td><span title="Codes:{urn:ietf:bcp:47 en}">English</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <system value="https://spor.ema.europa.eu/pmswi"/>
          <value value="EU/1/03/256/022"/>
        </identifier>
        <identifier>
          <system value="https://www.who-umc.org/phpid"/>
          <value value="0xe72f98caa2b13cb3ccb489a1a7945c91"/>
        </identifier>
        <type>
          <coding>
            <system value="http://hl7.org/fhir/medicinal-product-type"/>
            <code value="MedicinalProduct"/>
            <display value="Medicinal Product"/>
          </coding>
        </type>
        <domain>
          <coding>
            <system value="http://hl7.org/fhir/medicinal-product-domain"/>
            <code value="Human"/>
            <display value="Human use"/>
          </coding>
        </domain>
        <status>
          <coding>
            <system value="http://hl7.org/fhir/publication-status"/>
            <code value="active"/>
            <display value="active"/>
          </coding>
        </status>
        <legalStatusOfSupply>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="100000072084"/>
            <display
                     value="Medicinal product subject to medical prescription"/>
          </coding>
        </legalStatusOfSupply>
        <name>
          <productName
                       value="Humira 40 mg Solution for injection Subcutaneous use pre-filled syringe (glass)"/>
          <type>
            <coding>
              <system value="https://spor.ema.europa.eu/lists/220000000000"/>
              <code value="220000000001"/>
              <display value="Full name"/>
            </coding>
          </type>
          <part>
            <part value="Humira"/>
            <type>
              <coding>
                <system
                        value="https://spor.ema.europa.eu/lists/220000000000"/>
                <code value="220000000002"/>
                <display value="Invented name part"/>
              </coding>
            </type>
          </part>
          <part>
            <part value="Adalimumab"/>
            <type>
              <coding>
                <system
                        value="https://spor.ema.europa.eu/lists/220000000000"/>
                <code value="220000000003"/>
                <display value="Scientific name part"/>
              </coding>
            </type>
          </part>
          <part>
            <part value="40 mg"/>
            <type>
              <coding>
                <system
                        value="https://spor.ema.europa.eu/lists/220000000000"/>
                <code value="220000000004"/>
                <display value="Strength part"/>
              </coding>
            </type>
          </part>
          <part>
            <part value="Solution for injection"/>
            <type>
              <coding>
                <system
                        value="https://spor.ema.europa.eu/lists/220000000000"/>
                <code value="220000000005"/>
                <display value="Pharmaceutical dose form part"/>
              </coding>
            </type>
          </part>
          <usage>
            <country>
              <coding>
                <system value="urn:iso:std:iso:3166"/>
                <code value="ES"/>
                <display value="Spain"/>
              </coding>
            </country>
            <jurisdiction>
              <coding>
                <system value="urn:iso:std:iso:3166"/>
                <code value="ES"/>
                <display value="Spain"/>
              </coding>
            </jurisdiction>
            <language>
              <coding>
                <system value="urn:ietf:bcp:47"/>
                <code value="en"/>
                <display value="English"/>
              </coding>
            </language>
          </usage>
        </name>
      </MedicinalProductDefinition>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://hl7.eu/fhir/ig/gravitate-health/ManufacturedItemDefinition/mid-9b5b17469311c2ea4d1d08419748b4fb"/>
    <resource>
      <ManufacturedItemDefinition>
        <id value="mid-9b5b17469311c2ea4d1d08419748b4fb"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/ManufacturedItemDefinition-uv-epi"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="ManufacturedItemDefinition_mid-9b5b17469311c2ea4d1d08419748b4fb"> </a><p class="res-header-id"><b>Generated Narrative: ManufacturedItemDefinition mid-9b5b17469311c2ea4d1d08419748b4fb</b></p><a name="mid-9b5b17469311c2ea4d1d08419748b4fb"> </a><a name="hcmid-9b5b17469311c2ea4d1d08419748b4fb"> </a><a name="mid-9b5b17469311c2ea4d1d08419748b4fb-en-US"> </a><p><b>identifier</b>: <code>https://spor.ema.europa.eu/pmswi</code>/EU/1/03/256/001 (use: official, )</p><p><b>status</b>: Active</p><p><b>manufacturedDoseForm</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi/ 100000073863}">Solution for injection</span></p><p><b>unitOfPresentation</b>: <span title="Codes:{https://spor.ema.europa.eu/rmswi 200000002150}">Syringe</span></p></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://spor.ema.europa.eu/pmswi"/>
          <value value="EU/1/03/256/001"/>
        </identifier>
        <status value="active"/>
        <manufacturedDoseForm>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi/"/>
            <code value="100000073863"/>
            <display value="Solution for injection"/>
          </coding>
        </manufacturedDoseForm>
        <unitOfPresentation>
          <coding>
            <system value="https://spor.ema.europa.eu/rmswi"/>
            <code value="200000002150"/>
            <display value="Syringe"/>
          </coding>
        </unitOfPresentation>
      </ManufacturedItemDefinition>
    </resource>
  </entry>
</Bundle>