Gravitate Health FHIR Implementation Guide
0.1.0 - CI Build
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/joofio/test-epi-composition/ and changes regularly. See the Directory of published versions
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>What is in this leaflet</p><ol type=\"1\"><li>What Waylivra is and what it is used for</li><li>What you need to know before you use Waylivra</li><li>How to use Waylivra</li><li>Possible side effects</li><li>How to store Waylivra</li><li>Contents of the pack and other information</li></ol></div>"
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"text" : "1. What waylivra is and what it is used for"
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Waylivra contains the active substance volanesorsen, which helps to treat a condition called familial chylomicronemia syndrome (FCS). FCS is a genetic disease which gives rise to abnormally high levels of fats called triglycerides in the blood. This can lead to inflammation of your pancreas, causing severe pain. Together with a controlled low-fat diet, Waylivra helps to lower the levels of triglycerides in your blood.</p><p>Waylivra may be given after you have already received other medicines used to lower the levels of triglycerides in blood without them having much effect.</p><p>You will only be given Waylivra if genetic testing has confirmed you have FCS and your risk for pancreatitis is considered very high..</p><p>You should continue the very low-fat diet that your doctor has prescribed during treatment with Waylivra.</p><p>This medicine is intended for patients aged 18 years and above.</p></div>"
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Do not use Waylivra: if you are allergic to volanesorsen or any of the other ingredients in this medicine (listed in section 6). if you have a condition called thrombocytopenia, which means that you have a very low number of platelets in your blood (less than 140 x 109/L). You may notice this if you have an injury which causes bleeding and it takes a long time to stop (more than 5-6 minutes for a skin scratch). Your doctor will test for this before treatment with this medicine is started. You may not know that you have this condition until this point, or what might have caused it.</p><p>If any of the above apply to you, or you are not sure, talk to your doctor, nurse or pharmacist before using Waylivra.</p><p>Warnings and precautions<br/>Talk to your doctor, pharmacist or nurse before using Waylivra if you have or have had any of the following medical problems: Very high triglyceride levels which are not due to FCS. A low number of platelets, a type of cell in your blood that clump together to help it clot (thrombocytopenia); your doctor will do a blood test before you start using this medicine to check the number of platelets in your blood.<br/>Any liver or kidney problems.</p><p>Blood tests Your doctor will do a blood test before you start using this medicine to check the number of platelets, and then at regular intervals once you have started using Waylivra to check on platelet levels.<br/>You should see your doctor immediately if you have any signs of low platelet levels, such as unusual or prolonged bleeding, patches of red appearing on the skin (called petechiae), unexplained bruising, bleeding which will not stop, or nosebleeds, or if you get neck stiffness or a severe headache.</p><p>Your doctor may also do a blood test every 3 months to check for signs of damage to your liver. You should see your doctor immediately if you have any signs of liver damage, such as yellowing of your skin and eyeballs, pain or swelling in your abdomen, feeling or being sick, confusion or a general feeling of being unwell.</p><p>If necessary, your doctor may change how often you use this medicine, or may stop it for a period. It may be necessary to consult a doctor specialising in blood disorders to determine whether you should continue treatment with Waylivra or not.</p><p>Urine tests Your doctor may do a urine and/or blood test every 3 months to check for signs of damage to your kidneys. You should see your doctor immediately if you have any signs of kidney damage, such as swelling in your ankles, legs and feet, passing smaller amounts of urine than usual, shortness of breath, feeling sick, confusion or feeling very tired or drowsy.</p><p>Diet Before starting this medicine, you should be on a diet designed to help lower triglyceride levels in your blood.</p><p>It is important that you maintain this triglyceride-lowering diet whilst using Waylivra.</p><p>Children and adolescents Do not use Waylivra if you are under 18 years old. Waylivra has not been studied in patients under years old.</p><p>Other medicines and Waylivra Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines. It is important to tell your doctor if you are already being treated with any of the following: Medicines to prevent blood clots, e.g., acetylsalicylic acid, dipyridamol or warfarin. Other medicines that may change how your blood clots, including non-steroidal anti-inflammatory medicines like ibuprofen, medicines used to prevent heart attacks and strokes such as clopidogrel, ticagrelor and prasugrel, antibiotics such as penicillin, medicines such as ranitidine (used to reduce stomach acid), and quinine (used to treat malaria). Medicines that may cause problems with your liver, such as paracetamol.</p><p>Waylivra with alcohol The effect of using Waylivra with alcohol is not known. You should avoid alcohol during treatment with this medicine due to risk of liver issues.</p><p>Pregnancy and breast-feeding If you are pregnant or breast-feeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine. It is preferable to avoid the use of Waylivra during pregnancy. It is not known if Waylivra passes into breast milk. It is recommended that you discuss breast-feeding with your doctor to see what is best for you and your child.</p><p>Driving and using machines Waylivra is not likely to affect your ability to drive or use machines.</p><p>Sodium This medicine contains less than 1 mmol sodium (23 mg) per dose, that is to say essentially sodium- free .</p></div>"
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Always use this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.</p><p>Before you are given this medicine other causes of high levels of triglycerides, such as diabetes or problems with your thyroid, will be ruled out by your doctor.</p><p>Your doctor will tell you how often you should take this medicine. They may change how often you use it, or may stop it for a period or permanently, depending on the results of your blood and urine tests or occurrence of side effects.</p><p>You or your caregiver will be trained on how to use Waylivra according to the instructions in this leaflet. Waylivra should be injected under your skin (subcutaneous or SC administration) in the way the doctor, nurse or pharmacist has shown you, and you should make sure you inject all of the liquid in the syringe. Each single-use, pre-filled syringe of this medicine gives you a dose of 285 mg in 1.5 ml.</p><p>Before using this medicine, it is important that you read, understand, and closely follow the instructions for use.</p><p>Instructions for use are provided at the end of this leaflet.</p><p>If you use more Waylivra than you should If you inject too much Waylivra, contact your doctor or pharmacist, or attend a hospital emergency department immediately, even if there are no symptoms.</p><p>If you forget to use Waylivra If you miss a dose, contact your doctor to ask when to take your next dose. If a dose is missed and noticed within 48 hours, you should give the missed dose as soon as possible. If not noticed within hours, then the missed dose should be skipped and the next planned injection given. Do not inject more than one dose within 2 days.</p><p>If you stop using Waylivra<br/>Do not stop using Waylivra unless you have discussed stopping your medicine with your doctor.</p><p>If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.</p></div>"
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Like all medicines, this medicine can cause side effects, although not everybody gets them. Serious side effects If you get any of the following side effects, contact your doctor immediately:</p><ul><li>Symptoms that could indicate low counts of platelets in your blood (platelets are cells important for blood clotting). You should see your doctor immediately if you have any signs of low platelet levels, such as unusual or prolonged bleeding, patches of red appearing on the skin (called petechiae), unexplained bruising, bleeding which will not stop, or nosebleeds, or if you get neck stiffness or a severe headache.</li></ul><p>Other side effects</p><p>Very common (may affect more than 1 in 10 people)</p><ul><li>Injection site reactions (rash, pain, redness, heat or warmth, dryness, swelling, itching, tingling, hardening, hives, blistering, pimpling, bruising, bleeding, numbness, paleness, change in colour or a burning feeling at the injection site). You can reduce the likelihood of having injection site reaction if you wait for Waylivra to reach room temperature before injecting, and by applying ice to the injection site after injecting.</li><li>Headache</li><li>Muscle pain</li><li>Chills</li></ul><p>Common (may affect up to 1 in 10 people)</p><ul><li>Blood tests showing unusually high levels of white blood cells in your blood</li><li>Blood tests showing unusually low levels of white blood cells in your blood (known as lymphopenia)</li><li>Easy or excessive bruising, or bruising without an obvious cause</li><li>Bleeding under the skin that appears as a rash, bleeding from the gums or mouth, blood in the urine or stools, nosebleed, or unusually heavy menstrual period</li><li>An allergic reaction, the symptoms of which include skin rash, joint stiffness or fever</li><li>Blood or protein in the urine</li><li>Changes to the results of some blood tests, including: * an increase in the level of some constituents in your blood: creatinine, urea, transaminases, liver enzymes * an increase in blood clotting time * a fall in levels of haemoglobin in your blood * a fall in the rate of blood passing through the kidneys</li><li>Diabetes, the symptoms of which include increased thirst, frequent need to pass urine (particularly at night), extreme hunger, severe tiredness, and unexplained weight loss</li><li>Difficulty sleeping</li><li>Numbness, tingling or pins and needles, feeling faint or fainting, dizziness or shaking</li><li>Visual disturbances, such as flashing lights or brief, temporary blindness in one eye, bleeding under the surface of the eye, or blurred vision</li><li>High blood pressure</li><li>Hot flush, increased sweating, night sweats, feeling hot, pain, flu-like illness or a general feeling of being unwell</li><li>Cough, difficulty breathing, a blocked nose, swelling of the throat, wheezing</li><li>Feeling or being sick, dry mouth, diarrhoea, swelling of the neck, face or gums, stomach pain or swelling, indigestion</li><li>Skin redness, rash, pimples, thickening or scarring, or itchiness of the skin known as hives<br/>(urticaria)</li><li>Pain in the hands or feet, pain in the large joint of the arms and legs including the elbows, wrists, knees and ankles, other joint pain or stiffness, back pain, neck pain, jaw pain, muscle spasms, or other body pains</li><li>Severe tiredness (fatigue), weakness or lack of energy, fluid retention, chest pain unrelated to the heart</li></ul><p>Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. 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>"
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Keep this medicine out of the sight and reach of children.</p><p>Do not use this medicine after the expiry date which is stated on the carton and syringe label after EXP . Please note that the expiry date refers to the last day of that month.</p><p>Store in a refrigerator (2 - 8 C). Store in the original carton to protect from light.</p><p>Waylivra can be kept at room temperature (up to 30 C) in the original carton for up to 6 weeks after removing from the refrigerator. During this time this medicine may be kept at either room temperature or put back into the refrigerator, as needed. Record the date you first remove the pack from the refrigerator on the outer carton in the space indicated. If you do not use it within 6 weeks after first removing from the refrigerator, discard the medicine. If the expiry date on the syringe label has passed during the 6 week period at room temperature, do not use the syringe and discard it.</p><p>Do not use this medicine if the solution is cloudy or contains particles; it should be clear and colourless to slightly yellow.</p><p>Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.</p></div>"
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>What Waylivra contains<br/>The active substance is volanesorsen. Each ml contains 200 mg volanesorsen sodium, equivalent to 190 mg volanesorsen. Each single-dose pre-filled syringe contains 285 mg of volanesorsen in 1.5 ml solution.</p><p>The other ingredients are water for injections, sodium hydroxide and hydrochloric acid (to adjust acidity level, see section 2 under Sodium ).</p><p>What Waylivra looks like and contents of the pack Waylivra is provided in a carton as a single-dose syringe with needle and needle cap, pre-filled with a clear, colourless to pale yellow solution. It is filled to deliver 1.5 ml of solution upon full depression of the syringe s plunger.</p><p>It is available as either a carton containing 1 pre-filled syringe, or as a multipack of 4 (4 packs of 1-pack cartons) pre-filled syringes.</p><p>Marketing Authorisation Holder<br/>Akcea Therapeutics Ireland Ltd. St. James House 72 Adelaide Road, Dublin 2 D02 YIreland</p><p>Manufacturer Almac Pharma Services Ireland Ltd. Finnabair Industrial Estate Dundalk Co. Louth Ireland</p><p>This leaflet was last revised in</p><p>This medicine has been given conditional approval . This means that there is more evidence to come about this medicine. The European Medicines Agency will review new information on this medicine at least every year and this leaflet will be updated as necessary.</p><p>Other sources of information</p><p>Detailed information on this medicine is available on the European Medicines Agency web site:</p></div>"
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{
"system" : "https://spor.ema.europa.eu/lists/220000000000",
"code" : "220000000004",
"display" : "Strength part"
}
]
}
},
{
"part" : "nan",
"type" : {
"coding" : [
{
"system" : "https://spor.ema.europa.eu/lists/220000000000",
"code" : "220000000005",
"display" : "Pharmaceutical dose form part"
}
]
}
}
],
"usage" : [
{
"country" : {
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "EU",
"display" : "EU"
}
]
},
"jurisdiction" : {
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "EU",
"display" : "EU"
}
]
},
"language" : {
"coding" : [
{
"system" : "urn:ietf:bcp:47",
"code" : "en",
"display" : "en"
}
]
}
}
]
}
]
}
}
]
}
IG © 2021+ Gravitate Health Project. Package hl7.eu.fhir.ghepi#0.1.0 based on FHIR 5.0.0. Generated 2024-10-14
Links: Table of Contents |
QA Report
The Gravitate Health project has received funding from the IMI 2 Joint Undertaking under grant agreement No 945334.
This joint undertaking receives support from the EU H2020 research and innovation programme and EFPIA.
