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\" xml:lang=\"en\" lang=\"en\"><a name=\"Composition_composition-en-65cdaa8e626b314e9a691e6afef8bf66\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Composition composition-en-65cdaa8e626b314e9a691e6afef8bf66</b></p><a name=\"composition-en-65cdaa8e626b314e9a691e6afef8bf66\"> </a><a name=\"hccomposition-en-65cdaa8e626b314e9a691e6afef8bf66\"> </a><a name=\"composition-en-65cdaa8e626b314e9a691e6afef8bf66-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>http://ema.europa.eu/identifier</code>/EU/1/18/1352/001</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=\"Organization-mah-ema.html\">Organization ACME industry</a></p><p><b>title</b>: TEST PURPOSES ONLY - besremi</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>"
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"title" : "TEST PURPOSES ONLY - besremi",
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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 Besremi is and what it is used for</li><li>What you need to know before you use Besremi</li><li>How to use Besremi</li><li>Possible side effects</li><li>How to store Besremi</li><li>Contents of the pack and other information</li></ol></div>"
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"title" : "1. What besremi is and what it is used for",
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Besremi contains the active substance ropeginterferon alfa-2b, which belongs to the class of medicines called interferons. Interferons are produced by your immune system to block the growth of cancer cells.</p><p>Besremi is used as monotherapy for the treatment of polycythaemia vera in adults. Polycythaemia vera is a type of cancer in which the bone marrow produces too many red blood cells, white blood cells and platelets (cells that help the blood to clot).</p></div>"
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"title" : "2. What you need to know before you take besremi",
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"text" : "2. What you need to know before you take besremi"
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Do not use Besremi</p><ul><li>if you are allergic to ropeginterferon alfa-2b or any of the other ingredients of this medicine (listed in section 6).</li><li>if you have thyroid disease that is not controlled with medicines.</li><li>if you have or had severe mental disorders (such as depression or suicidal thoughts or if you tried to kill yourself).</li><li>if you have recently had severe heart problems (such as heart attack or stroke)</li><li>if you have or had an autoimmune disease (such as rheumatoid arthritis, psoriasis or inflammatory bowel disease).</li><li>if you had an organ transplantation and you take medicines which suppress your immune system.</li><li>if you take telbivudine (a medicine used to treat hepatitis B infection).</li><li>if you have advanced, uncontrolled liver disease.</li><li>if you have severe kidney disease (with your kidneys working at less than 15% of their normal ability).</li></ul><p>Warnings and precautions Talk to your doctor before using Besremi:</p><ul><li>if you have thyroid disease.</li><li>if you have diabetes or high blood pressure your doctor may ask you to have an eye examination.</li><li>if you have liver problems you will have blood tests regularly to check how your liver is working if you are on a long-term Besremi therapy.</li><li>if you have kidney problems.</li><li>if you have psoriasis or other skin problems because they may get worse during treatment with Besremi.</li></ul><p>Once you have started Besremi treatment, talk to your doctor:</p><ul><li>if you develop symptoms of depression (such as feelings of sadness, dejection, and suicidal thoughts).</li><li>if you develop signs of a severe allergic reaction (such as difficulty in breathing, wheezing or hives) while using Besremi if this is the case you will need to seek medical help immediately.</li><li>if you develop symptoms of a cold or other respiratory infection (such as difficulty in breathing, cough, fever and chest pain).</li><li>if you have changes in your vision you must tell your doctor and have an immediate eye examination. Severe eye problems may occur during Besremi therapy. Your doctor will usually check your vision before starting your treatment. If you have health problems which may lead to eye problems such as diabetes or high blood pressure, you doctor should check your vision also during treatment. If your vision worsens, your doctor may decide to discontinue your treatment.</li></ul><p>Dental and gum disorders, which may lead to loss of teeth, can occur with interferon medicines. In addition, dry mouth could damage teeth and the lining of the mouth during long-term treatment with Besremi. You should brush your teeth thoroughly twice daily and have regular dental checks.</p><p>It will need a certain time to reach your individual optimal dose of Besremi. Your doctor will decide if it is necessary to treat you with another medicine for an early reduction of your blood cell number to prevent blood clots and bleeding.</p><p>Children and adolescents Do not give this medicine to children and adolescents because no information is available on the use of Besremi in this age group.</p><p>Other medicines and Besremi Tell your doctor or pharmacist if you are using, have recently used or might use any other medicines.</p><p>Do not use Besremi if you are taking telbivudine (for treating hepatitis B) since the combination of these medicines increases the risk of peripheral neuropathy (numbness, tingling, or burning sensations in the arms and legs). Tell your doctor if you are being treated with telbivudine.</p><p>Tell your doctor especially if you are taking any of the following medicines:</p><ul><li>theophylline (a medicine used to treat respiratory diseases such as asthma)</li><li>methadone (a medicine used to treat pain or opioid dependence)</li><li>vortioxetine or risperidone (medicines used to treat mental disorders)</li><li>anti-cancer medicines such as those stopping or slowing the growth of blood-forming cells in the bone marrow (e.g. hydroxycarbamide)</li><li>medicines that work on the central nervous system to relieve pain, help you sleep, or have a calming effect (e.g. morphine, midazolam)</li></ul><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.</p><p>Pregnancy The effect of Besremi during pregnancy is not known. The use of Besremi is not recommended during pregnancy. If you are a woman of childbearing potential, your doctor will discuss with you if effective birth control should be used during your treatment with Besremi.</p><p>Breast-feeding It is not known if Besremi is present in breast milk. Your doctor will help you decide if you have to stop breast-feeding when you are using this medicine.</p><p>Driving and using machines Do not drive or use machines if you feel dizzy, sleepy or confused while using Besremi.</p><p>Besremi contains benzyl alcohol This medicine contains 5 mg benzyl alcohol in each 0.5 mL. Benzyl alcohol may cause allergic reactions. Ask your doctor or pharmacist for advice:</p><ul><li>if you are pregnant or breast-feeding.</li><li>if you have a liver or kidney disease. This is because large amounts of benzyl alcohol can build-up in your body and may cause side effects (called metabolic acidosis ).</li></ul><p>Besremi contains sodium This medicine contains less than 1 mmol sodium (23 mg) per ml, that is to say essentially sodium- free .</p></div>"
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"title" : "3. How to take besremi",
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><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.</p><p>The dose will be set individually for you by your doctor for your condition. The usual starting dose of Besremi is 100 microgram every 2 weeks. Your doctor will then increase your dose stepwise and may adjust your dose during treatment. Your doctor will reduce your starting dose to 50 micrograms if you have severe kidney problems.</p><p>This medicine is for subcutaneous use which means that it is injected in the tissue under your skin. It should not be injected into an area of the body where the skin is irritated, reddened, bruised, infected, or scarred. If you are injecting this medicine yourself, you will get clear instructions on how to prepare and inject it. To prevent passing on infectious diseases, you should never share Besremi pre-filled pen with anyone else, even when the needle is changed.</p><p>Details on how to prepare and inject Besremi are given in the Instructions for Use. Read them before you start using Besremi.</p><p>If you use more Besremi than you should Tell your doctor as soon as possible.</p><p>If you forget to use Besremi You should inject the dose as soon as you remember. However, if more than 2 days have passed since you missed the dose, leave out the dose and inject the next dose when it is due. Do not inject a double dose to make up for a forgotten dose. Check with your doctor or pharmacist if you are not sure.</p><p>If you stop using Besremi Do not stop using Besremi before you have talked to your doctor.</p><p>If you have any further questions on the use of this medicine, ask your doctor or pharmacist.</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.</p><p>Contact your doctor immediately if you notice any of the following serious side effects during your treatment with Besremi:</p><p>Common side effects (may affect up to 1 in 10 people):</p><ul><li>changes in your heartbeat (when the heart beats very fast and uneven)</li></ul><p>Uncommon side effects (may affect up to 1 in 100 people):</p><ul><li>attempted suicide, thoughts about killing yourself</li><li>loss of vision which may be caused by bleeding in the retina (the retina is the light-sensitive layer in the eye), or by build-up of fat in or under the retina</li></ul><p>Rare side effects (may affect up to 1 in 1,000 people):</p><ul><li>loss of vision which may be caused by damage to the retina (such as obstruction of the blood vessels in the eye) or the optic nerve</li></ul><p>Very rare side effects (may affect up to 1 in 10,000 people):</p><ul><li>blindness</li><li>breathing problems including shortness of breath, cough and chest pain which may be caused by lung infiltration, pneumonia (lung infection), pulmonary arterial hypertension (high blood pressure in the blood vessels bringing blood from the heart to the lungs) and pulmonary fibrosis (a lung disease where scars are formed in the lung tissue)</li></ul><p>Side effects with frequency not known (cannot be estimated from the available data):</p><ul><li>detachment of the retina (you may experience eye problems including changes in vision)</li></ul><p>Other side effects</p><p>Very common side effects (may affect more than 1 in 10 people):</p><ul><li>decrease in the number of a type of white blood cells (called leucocytes) and in blood clotting cells (called platelets)</li><li>joint or muscle pain</li><li>flu-like symptoms, feeling tired</li><li>in blood tests: increase of an enzyme called gamma-glutamyltransferase</li></ul><p>Common side effects (may affect up to 1 in 10 people):</p><ul><li>infection of the respiratory tract, runny or stuffy nose, fungal infections, flu</li><li>decrease in the number or size of red blood cells</li><li>increase or decrease in the thyroid gland activity, increase of thyroid stimulating hormone, inflammation of the thyroid gland</li><li>increase of triglycerides (a type of lipid) in the blood, decreased appetite</li><li>aggressive behaviour, feeling depressed, feeling anxious, problems with falling asleep or staying asleep, mood changes, lacking bodily energy or motivation</li><li>headache, feeling dizzy, reduced sense of touch or sensation, feeling sleepy, sensation of tingling and pins and needles</li><li>dry eyes</li><li>damage of the capillaries (very small blood vessels) in the body</li><li>breathing problems</li><li>diarrhoea, nausea, abdominal pain or stomach discomfort, constipation, dry mouth</li><li>liver disorder, increase in certain liver enzymes (shown in blood tests)</li><li>itching, hair loss, rash, redness of skin, psoriasis, dry and scaly skin, acne, thickening of the outer layer of the skin, increased sweating</li><li>a disorder called Sjogren's syndrome where the body s immune system attacks glands that produce fluid (such as the tear and saliva glands), arthritis, pain in arms and legs, bone pain, painful sudden tightening of a muscle</li><li>fever, weakness, chills, general health problems, irritation or redness at the site of injection, decreasing body weight</li><li>in blood tests: antibodies which are produced by the body s immune system, increase of an enzyme called lactate dehydrogenase</li></ul><p>Uncommon side effects (may affect up to 1 in 100 people):</p><ul><li>infection and re-infection with herpes, bacterial infections</li><li>increase in the number of platelets</li><li>autoimmune disorder of the thyroid gland, sarcoidosis (areas of inflamed tissue in different parts of the body)</li><li>diabetes</li><li>panic attack, hallucination (seeing, hearing or feeling things that are not there), feeling stressed, feeling nervous, lack of interest in activities, nightmare, irritability, confusion</li><li>damage to the nervous system, migraine, mental disorder (health condition involving changes in thinking, emotion or behaviour), visual or sensory disturbances, shaky hands</li><li>eye discomfort, eyelid eczema</li><li>hearing loss, ringing in ears (tinnitus), spinning feeling (vertigo)</li><li>heart disorders such as heart block (a disorder in the heart s electrical activity), blood clots in the blood vessels of the heart, leakage of the aortic valve</li><li>high blood pressure, reduced blood supply to certain parts of the body, haematoma (collection of blood under the skin), flushing</li><li>inflammation of lung tissue, coughing, nosebleed, sore throat</li><li>inflammation of the stomach, abdominal wall disorder, intestinal gas, indigestion, painful swallowing, bleeding gums</li><li>inflammation of the liver, damage to the liver, enlarged liver</li><li>sensitivity to sunlight, peeling of the skin, nail disorder</li><li>muscle weakness, neck pain, groin pain</li><li>inflammation of the bladder, painful urination, increased need to urinate, inability to urinate</li><li>sexual problems</li><li>pain or itching at the site of injection, sensitivity to weather change</li><li>non-acute porphyria (a liver disorder in which substances called porphyrins build up in the skin causing local skin damage, such as rashes, blisters, sores or discomfort, upon sun exposure)</li><li>in blood tests: increase of uric acid, antibodies produced by the body s immune system against red blood cells</li></ul><p>Rare side effects (may affect up to 1 in 1,000 people):</p><ul><li>bipolar disorders (mood disorders with episodes of sadness and excitement), mania (extreme excitement or unreasonable enthusiasm)</li><li>cardiomyopathy (diseases that affect the heart muscle), angina pectoris (a severe chest pain as a result of blockage of the heart vessels)</li><li>liver failure</li></ul><p>Very rare side effects (may affect up to 1 in 10,000 people):</p><ul><li>idiopathic or thrombotic thrombocytopenic purpura (increased bruising, bleeding, decreased platelets, anaemia and extreme weakness)</li><li>myocardial ischemia (reduced blood flow to your heart muscle)</li></ul><p>Side effects with frequency not known (cannot be estimated from the available data):</p><ul><li>Vogt-Koyanagi-Harada disease (a rare disease that can lead to loss of vision, hearing and skin pigmentation), severe allergic reaction</li><li>discolouration of the skin</li><li>periodontal (affecting gums) and dental disorders, change in colour of the tongue</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 label and the outer carton after EXP . The expiry date refers to the last day of that month.</p><p>Store in a refrigerator (2 C 8 C). Do not freeze. Keep the pre-filled pen in the outer carton in order to protect from light.</p><p>Once opened, the pre-filled pen may be stored for a maximum of 30 days in the refrigerator (2 C - 8 C) when stored with the pen cap on and kept in the outer carton in order to protect from light.</p><p>Do not use this medicine if you notice that the pre-filled pen appears damaged, the solution is cloudy, has particles or flakes, or has any colour other than 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 Besremi contains</p><ul><li>The active substance is ropeginterferon alfa-2b.</li></ul><p>Each pre-filled pen of 0.5 mL solution contains 250 micrograms of ropeginterferon alfa-2b as measured on a protein basis, corresponding to 500 micrograms/mL.</p><ul><li>The other ingredients are sodium chloride, polysorbate 80, benzyl alcohol, anhydrous sodium acetate, glacial acetic acid, and water for injections. For benzyl alcohol and sodium, see section 2 Besremi contains benzyl alcohol and Besremi contains sodium .</li></ul><p>What Besremi looks like and contents of the pack Besremi is presented as a solution for injection (injection) in a pre-filled pen. Each pre-filled pen contains 0.5 mL of solution. It is available in packs containing:</p><ul><li>1 pre-filled pen and 2 injection needles (Type: mylife Clickfine 8mm)</li><li>3 pre-filled pens and 6 injection needles (Type: mylife Clickfine 8mm).</li></ul><p>Marketing Authorisation Holder and Manufacturer AOP Orphan Pharmaceuticals GmbH Leopold-Ungar-Platz 2 1190 Vienna Austria</p><p>This leaflet was last revised in .</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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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MedicinalProductDefinition_mp65cdaa8e626b314e9a691e6afef8bf66\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MedicinalProductDefinition mp65cdaa8e626b314e9a691e6afef8bf66</b></p><a name=\"mp65cdaa8e626b314e9a691e6afef8bf66\"> </a><a name=\"hcmp65cdaa8e626b314e9a691e6afef8bf66\"> </a><a name=\"mp65cdaa8e626b314e9a691e6afef8bf66-en-US\"> </a><p><b>identifier</b>: <code>http://ema.europa.eu/identifier</code>/EU/1/18/1352/001</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>: Besremi 250 micrograms/0.5 mL solution for injection in pre-filled pen</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>: nan</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>: nan</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>: nan</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>: nan</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 EU}\">EU</span></td><td><span title=\"Codes:{urn:iso:std:iso:3166 EU}\">EU</span></td><td><span title=\"Codes:{urn:ietf:bcp:47 en}\">en</span></td></tr></table></blockquote></div>"
},
"identifier" : [
{
"system" : "http://ema.europa.eu/identifier",
"value" : "EU/1/18/1352/001"
}
],
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/medicinal-product-type",
"code" : "MedicinalProduct",
"display" : "Medicinal Product"
}
]
},
"domain" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/medicinal-product-domain",
"code" : "Human",
"display" : "Human use"
}
]
},
"status" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/publication-status",
"code" : "active",
"display" : "active"
}
]
},
"legalStatusOfSupply" : {
"coding" : [
{
"system" : "https://spor.ema.europa.eu/rmswi",
"code" : "100000072084",
"display" : "Medicinal product subject to medical prescription"
}
]
},
"name" : [
{
"productName" : "Besremi 250 micrograms/0.5 mL solution for injection in pre-filled pen",
"type" : {
"coding" : [
{
"system" : "https://spor.ema.europa.eu/lists/220000000000",
"code" : "220000000001",
"display" : "Full name"
}
]
},
"part" : [
{
"part" : "nan",
"type" : {
"coding" : [
{
"system" : "https://spor.ema.europa.eu/lists/220000000000",
"code" : "220000000002",
"display" : "Invented name part"
}
]
}
},
{
"part" : "nan",
"type" : {
"coding" : [
{
"system" : "https://spor.ema.europa.eu/lists/220000000000",
"code" : "220000000003",
"display" : "Scientific name part"
}
]
}
},
{
"part" : "nan",
"type" : {
"coding" : [
{
"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.
