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 xmlns="http://www.w3.org/1999/xhtml"><p>What is in this leaflet</p><ol type="1"><li>What Karvezide is and what it is used for</li><li>What you need to know before you take Karvezide</li><li>How to take Karvezide</li><li>Possible side effects</li><li>How to store Karvezide</li><li>Contents of the pack and other information</li></ol></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Karvezide is a combination of two active substances, irbesartan and hydrochlorothiazide. Irbesartan belongs to a group of medicines known as angiotensin-II receptor antagonists. Angiotensin- II is a substance produced in the body that binds to receptors in blood vessels causing them to tighten. This results in an increase in blood pressure. Irbesartan prevents the binding of angiotensin-II to these receptors, causing the blood vessels to relax and the blood pressure to lower. Hydrochlorothiazide is one of a group of medicines (called thiazide diuretics) that causes increased urine output and so causes a lowering of blood pressure. The two active ingredients in Karvezide work together to lower blood pressure further than if either was given alone.</p><p>Karvezide is used to treat high blood pressure, when treatment with irbesartan or hydrochlorothiazide alone did not provide adequate control of your blood pressure.</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Do not take Karvezide</p><p>if you are allergic to irbesartan or any of the other ingredients of this medicine (listed in section 6)</p><p>if you are allergic to hydrochlorothiazide or any other sulfonamide-derived medicines</p><p>if you are more than 3 months pregnant. (It is also better to avoid Karvezide in early pregnancy see pregnancy section)</p><p>if you have severe liver or kidney problems</p><p>if you have difficulty in producing urine</p><p>if your doctor determines that you have persistently high calcium or low potassium levels in your blood</p><p>if you have diabetes or impaired kidney function and you are treated with a blood pressure lowering medicine containing aliskiren.</p><p>Warnings and precautions Talk to your doctor before taking Karvezide and if any of the following apply to you:</p><p>if you get excessive vomiting or diarrhoea</p><p>if you suffer from kidney problems or have a kidney transplant</p><p>if you suffer from heart problems</p><p>if you suffer from liver problems</p><p>if you suffer from diabetes</p><p>if you develop low blood sugar levels (symptoms may include sweating, weakness, hunger, dizziness, trembling, headache, flushing or paleness, numbness, having a fast, pounding heart beat), particularly if you are being treated for diabetes.</p><p>if you suffer from lupus erythematosus (also known as lupus or SLE)</p><p>if you suffer from primary aldosteronism (a condition related to high production of the hormone aldosterone, which causes sodium retention and, in turn, an increase in blood pressure).</p><p>if you are taking any of the following medicines used to treat high blood pressure: * an ACE-inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems. * aliskiren.</p><p>if you have had skin cancer or if you develop an unexpected skin lesion during the treatment. Treatment with hydrochlorothiazide, particularly long term use with high doses, may increase the risk of some types of skin and lip cancer (non-melanoma skin cancer). Protect your skin from sun exposure and UV rays while taking Karvezide.</p><p>if you experienced breathing or lung problems (including inflammation or fluid in the lungs) following hydrochlorothiazide intake in the past. If you develop any severe shortness of breath or difficulty breathing after taking Karvezide, seek medical attention immediately.</p><p>Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.</p><p>See also information under the heading Do not take Karvezide .</p><p>You must tell your doctor if you think you are (or might become) pregnant. Karvezide is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at that stage (see pregnancy section).</p><p>You should also tell your doctor:</p><p>if you are on a low-salt diet</p><p>if you have signs such as abnormal thirst, dry mouth, general weakness, drowsiness, muscle pain or cramps, nausea, vomiting, or an abnormally fast heart beat which may indicate an excessive effect of hydrochlorothiazide (contained in Karvezide)</p><p>if you experience an increased sensitivity of the skin to the sun with symptoms of sunburn (such as redness, itching, swelling, blistering) occurring more quickly than normal</p><p>if you are going to have an operation (surgery) or be given anaesthetics</p><p>if you have decrease in your vision or pain in one or both of your eyes while taking Karvezide. These could be symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or an increase of pressure in your eye (glaucoma) and can happen within hours to a week of taking Karvezide. This can lead to permanent vision loss, if not treated. If you earlier have had a penicillin or sulfonamide allergy, you can be at higher risk of developing this. You should discontinue Karvezide treatment and seek prompt medical attention.</p><p>The hydrochlorothiazide contained in this medicine could produce a positive result in an anti-doping test.</p><p>Children and adolescents Karvezide should not be given to children and adolescents (under 18 years).</p><p>Other medicines and Karvezide Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.</p><p>Diuretic agents such as the hydrochlorothiazide contained in Karvezide may have an effect on other medicines. Preparations containing lithium should not be taken with Karvezide without close supervision by your doctor.</p><p>Your doctor may need to change your dose and/or to take other precautions: If you are taking an ACE-inhibitor or aliskiren (see also information under the headings Do not take Karvezide and Warnings and precautions ).</p><p>You may need to have blood checks if you take:</p><p>potassium supplements</p><p>salt substitutes containing potassium</p><p>potassium sparing medicines or other diuretics (water tablets)</p><p>some laxatives</p><p>medicines for the treatment of gout</p><p>therapeutic vitamin D supplements</p><p>medicines to control heart rhythm</p><p>medicines for diabetes (oral agents as repaglinide or insulins)</p><p>carbamazepine (a medicine for the treatment of epilepsy).</p><p>It is also important to tell your doctor if you are taking other medicines to reduce your blood pressure, steroids, medicines to treat cancer, pain killers, arthritis medicines, or colestyramine and colestipol resins for lowering blood cholesterol.</p><p>Karvezide with food and drink Karvezide can be taken with or without food.</p><p>Due to the hydrochlorothiazide contained in Karvezide, if you drink alcohol while on treatment with this medicine, you may have an increased feeling of dizziness on standing up, specially when getting up from a sitting position.</p><p>Pregnancy, breast-feeding and fertility</p><p>Pregnancy You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Karvezide before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Karvezide. Karvezide is not recommended in early pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.</p><p>Breast-feeding Tell your doctor if you are breast-feeding or about to start breast-feeding. Karvezide is not recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.</p><p>Driving and using machines Karvezide is unlikely to affect your ability to drive or use machines. However, occasionally dizziness or weariness may occur during treatment of high blood pressure. If you experience these, talk to your doctor before attempting to drive or use machines.</p><p>Karvezide contains lactose. If you have been told by your doctor that you have an intolerance to some sugars (e.g. lactose), contact your doctor before taking this medicinal product.</p><p>Karvezide contains sodium. This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially sodium-free .</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.</p><p>Dosage The recommended dose of Karvezide is one or two tablets a day. Karvezide will usually be prescribed by your doctor when your previous treatment did not reduce your blood pressure enough. Your doctor will instruct you how to switch from the previous treatment to Karvezide.</p><p>Method of administration Karvezide is for oral use. Swallow the tablets with a sufficient amount of fluid (e.g. one glass of water). You can take Karvezide with or without food. Try to take your daily dose at about the same time each day. It is important that you continue to take Karvezide until your doctor tells you otherwise.</p><p>The maximal blood pressure lowering effect should be reached 6-8 weeks after beginning treatment.</p><p>If you take more Karvezide than you should If you accidentally take too many tablets, contact your doctor immediately.</p><p>Children should not take Karvezide Karvezide should not be given to children under 18 years of age. If a child swallows some tablets, contact your doctor immediately.</p><p>If you forget to take Karvezide If you accidentally miss a daily dose, just take the next dose as normal. Do not take a double dose to make up for a forgotten dose.</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 xmlns="http://www.w3.org/1999/xhtml"><p>Like all medicines, this medicine can cause side effects, although not everybody gets them. Some of these effects may be serious and may require medical attention.</p><p>Rare cases of allergic skin reactions (rash, urticaria), as well as localised swelling of the face, lips and/or tongue have been reported in patients taking irbesartan. If you get any of the above symptoms or get short of breath, stop taking Karvezide and contact your doctor immediately.</p><p>The frequency of the side effects listed below is defined using the following convention: Common: may affect up to 1 in 10 people Uncommon: may affect up to 1 in 100 people</p><p>Side effects reported in clinical studies for patients treated with Karvezide were:</p><p>Common side effects (may affect up to 1 in 10 people):</p><p>nausea/vomiting</p><p>abnormal urination</p><p>fatigue</p><p>dizziness (including when getting up from a lying or sitting position)</p><p>blood tests may show raised levels of an enzyme that measures the muscle and heart function (creatine kinase) or raised levels of substances that measure kidney function (blood urea nitrogen, creatinine). If any of these side effects causes you problems, talk to your doctor.</p><p>Uncommon side effects -may affect up to 1 in 100 people):</p><p>diarrhoea</p><p>low blood pressure</p><p>fainting</p><p>heart rate increased</p><p>flushing</p><p>swelling</p><p>sexual dysfunction (problems with sexual performance)</p><p>blood tests may show lowered levels of potassium and sodium in your blood. If any of these side effects causes you problems, talk to your doctor.</p><p>Side effects reported since the launch of Karvezide Some undesirable effects have been reported since marketing of Karvezide. Undesirable effects where the frequency is not known are: headache, ringing in the ears, cough, taste disturbance, indigestion, pain in joints and muscles, liver function abnormal and impaired kidney function, increased level of potassium in your blood and allergic reactions such as rash, hives, swelling of the face, lips, mouth, tongue or throat. Uncommon cases of jaundice (yellowing of the skin and/or whites of the eyes) have also been reported.</p><p>As for any combination of two active substances, side effects associated with each individual component cannot be excluded.</p><p>Side effects associated with irbesartan alone In addition to the side effects listed above, chest pain, severe allergic reactions (anaphylactic shock), decreased number of red blood cells (anaemia symptoms may include tiredness, headaches, being short of breath when exercising, dizziness and looking pale) and decrease in the number of platelets (a blood cell essential for the clotting of the blood) and low blood sugar levels have also been reported.</p><p>Side effects associated with hydrochlorothiazide alone Loss of appetite; stomach irritation; stomach cramps; constipation; jaundice (yellowing of the skin and/or whites of the eyes); inflammation of the pancreas characterised by severe upper stomach pain, often with nausea and vomiting; sleep disorders; depression; blurred vision; lack of white blood cells, which can result in frequent infections, fever; decrease in the number of platelets (a blood cell essential for the clotting of the blood), decreased number of red blood cells (anaemia) characterised by tiredness, headaches, being short of breath when exercising, dizziness and looking pale; kidney disease; lung problems including pneumonia or build-up of fluid in the lungs; increased sensitivity of the skin to the sun; inflammation of blood vessels; a skin disease characterized by the peeling of the skin all over the body; cutaneous lupus erythematosus, which is identified by a rash that may appear on the face, neck, and scalp; allergic reactions; weakness and muscle spasm; altered heart rate; reduced blood pressure after a change in body position; swelling of the salivary glands; high sugar levels in the blood; sugar in the urine; increases in some kinds of blood fat; high uric acid levels in the blood, which may cause gout.</p><p>Very rare side effects (may affect up to 1 in 10,000 people): Acute respiratory distress (signs include severe shortness of breath, fever, weakness, and confusion).</p><p>Not known (frequency cannot be estimated from the available data): skin and lip cancer (non- melanoma skin cancer), decrease in vision or pain in your eyes due to high pressure (possible signs of fluid accumulation in the vascular layer of the eye (choroidal effusion) or acute angle-closure glaucoma).</p><p>It is known that side effects associated with hydrochlorothiazide may increase with higher doses of hydrochlorothiazide.</p><p>Reporting of side effects If you get 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</p><p>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 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 on the blister after EXP. The expiry date refers to the last day of that month.</p><p>Do not store above 30 C.</p><p>Store in the original package in order to protect from moisture.</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 xmlns="http://www.w3.org/1999/xhtml"><p>What Karvezide contains</p><p>The active substances are irbesartan and hydrochlorothiazide. Each tablet of Karvezide 150 mg/12.5 mg contains 150 mg irbesartan and 12.5 mg hydrochlorothiazide.</p><p>The other ingredients are microcrystalline cellulose, croscarmellose sodium, lactose monohydrate, magnesium stearate, colloidal hydrated silica, pregelatinised maize starch, red and yellow ferric oxides (E172). Please see section 2 Karvezide contains lactose .</p><p>What Karvezide looks like and contents of the pack Karvezide 150 mg/12.5 mg tablets are peach, biconvex, oval-shaped, with a heart debossed on one side and the number 2775 engraved on the other side.</p><p>Karvezide 150 mg/12.5 mg tablets are supplied in blister packs of 14, 28, 56 or 98 tablets. Unit dose blister packs of 56 x 1 tablet for delivery in hospitals are also available.</p><p>Not all pack sizes may be marketed.</p><p>Marketing Authorisation Holder Sanofi Winthrop Industrie 82 avenue Raspail 94250 Gentilly France</p><p>Manufacturer SANOFI WINTHROP INDUSTRIE 1, rue de la Vierge Ambar s & Lagrave F-33565 Carbon Blanc Cedex - France</p><p>SANOFI WINTHROP INDUSTRIE 30-36 Avenue Gustave Eiffel 37100 Tours - France</p><p>For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:</p><p>Belgi /Belgique/Belgien Sanofi Belgium T l/Tel: +32 (0)2 710 54 Lietuva Swixx Biopharma UAB Tel: +370 5 236 91<br/>Swixx Biopharma EOOD .: +359 (0)2 4942 Luxembourg/Luxemburg Sanofi Belgium<br/>T l/Tel: +32 (0)2 710 54 00 (Belgique/Belgien)</p><p>esk republika sanofi-aventis, s.r.o. Tel: +420 233 086 Magyarorsz g sanofi-aventis zrt., Magyarorsz g Tel.: +36 1 505 0Danmark Sanofi A/S Tlf: +45 45 16 70 Malta Sanofi S.r.l. Tel: +39 02 39394Deutschland Sanofi-Aventis Deutschland GmbH Tel: 0800 52 52 Tel. aus dem Ausland: +49 69 305 21 Nederland Sanofi B.V. Tel: +31 20 245 4Eesti Swixx Biopharma O<br/>Tel: +372 640 10 Norge sanofi-aventis Norge AS Tlf: +47 67 10 71<br/>Sanofi-Aventis<br/>: +30 210 900 16 sterreich sanofi-aventis GmbH Tel: +43 1 80 185 0</p><p>Espa a sanofi-aventis, S.A. Tel: +34 93 485 94 Polska sanofi-aventis Sp. z o.o. Tel.: +48 22 280 00 France Sanofi Winthrop Industrie T l: 0 800 222 Appel depuis l tranger: +33 1 57 63 23 Portugal Sanofi - Produtos Farmac uticos, Lda Tel: +351 21 35 89 Hrvatska Swixx Biopharma d.o.o. Tel: +385 1 2078 Rom nia Sanofi Romania SRL Tel: +40 (0) 21 317 31 Ireland sanofi-aventis Ireland Ltd. T/A SANOFI Tel: +353 (0) 1 403 56 Slovenija Swixx Biopharma d.o.o. Tel: +386 1 235 51 sland Vistor hf. S mi: +354 535 7Slovensk republika Swixx Biopharma s.r.o. Tel: +421 2 208 33 Italia Sanofi S.r.l. Tel: 800 536Suomi/Finland Sanofi Oy Puh/Tel: +358 (0) 201 200<br/>C.A. Papaellinas Ltd. : +357 22 741Sverige Sanofi AB Tel: +46 (0)8 634 50 Latvija Swixx Biopharma SIA Tel: +371 6 616 47 United Kingdom (Northern Ireland) sanofi-aventis Ireland Ltd. T/A SANOFI Tel: +44 (0) 800 035 2This leaflet was last revised in</p><p>Detailed information on this medicine is available on the European Medicines Agency web site:</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><a name="MedicinalProductDefinition_mpd0672eae48edc2b3744742b0b1ff7c9b"> </a><p class="res-header-id"><b>Generated Narrative: MedicinalProductDefinition mpd0672eae48edc2b3744742b0b1ff7c9b</b></p><a name="mpd0672eae48edc2b3744742b0b1ff7c9b"> </a><a name="hcmpd0672eae48edc2b3744742b0b1ff7c9b"> </a><a name="mpd0672eae48edc2b3744742b0b1ff7c9b-en-US"> </a><p><b>identifier</b>: <code>http://ema.europa.eu/identifier</code>/EU/1/98/085/001-003</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>: Karvezide 150 mg/12.5 mg tablets.</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>
</text>
<identifier>
<system value="http://ema.europa.eu/identifier"/>
<value value="EU/1/98/085/001-003"/>
</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="Karvezide 150 mg/12.5 mg tablets."/>
<type>
<coding>
<system value="https://spor.ema.europa.eu/lists/220000000000"/>
<code value="220000000001"/>
<display value="Full name"/>
</coding>
</type>
<part>
<part value="nan"/>
<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="nan"/>
<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="nan"/>
<type>
<coding>
<system
value="https://spor.ema.europa.eu/lists/220000000000"/>
<code value="220000000004"/>
<display value="Strength part"/>
</coding>
</type>
</part>
<part>
<part value="nan"/>
<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="EU"/>
<display value="EU"/>
</coding>
</country>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="EU"/>
<display value="EU"/>
</coding>
</jurisdiction>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<code value="en"/>
<display value="en"/>
</coding>
</language>
</usage>
</name>
</MedicinalProductDefinition>
</resource>
</entry>
</Bundle>
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.
